Organization
THE HEALTH AND WELLNESS CLUB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLYN YARDE (OWNER)
(347) 881-5389
Entity
Organization
Contact information
Practice address
5006 AVENUE L, BROOKLYN, NY 11234-3210
(347) 881-5389
Mailing address
5006 AVENUE L, BROOKLYN, NY 11234-3210
(347) 881-5389
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
519593
STATE LICENSE NUMBER
NY
Enumeration date
09/10/2021
Last updated
09/10/2021
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