Provider Demographics
NPI:1679382758
Name:PATHWAY HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:PATHWAY HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:TANGI
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:240-564-8955
Mailing Address - Street 1:14502 GREENVIEW DR STE 500
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-4245
Mailing Address - Country:US
Mailing Address - Phone:240-564-8955
Mailing Address - Fax:
Practice Address - Street 1:14502 GREENVIEW DR STE 500
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-4245
Practice Address - Country:US
Practice Address - Phone:240-564-8955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health