Organization
REFINED MEDICAL WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NYCHOLLE GAVILANES MD (MEMBER)
(516) 704-7447
Entity
Organization
Contact information
Practice address
3400 NESCONSET HWY STE 104, EAST SETAUKET, NY 11733-3327
(516) 704-7447
Mailing address
3400 NESCONSET HWY STE 104, EAST SETAUKET, NY 11733-3327
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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