Provider Demographics
NPI:1578459319
Name:DIGESTIVE HEALTH AND WELLNESS
Entity type:Organization
Organization Name:DIGESTIVE HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZRATJEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-577-3790
Mailing Address - Street 1:5340 E 131ST AVE UNIT 103
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1244
Mailing Address - Country:US
Mailing Address - Phone:732-658-4662
Mailing Address - Fax:
Practice Address - Street 1:5340 E 131ST AVE UNIT 103
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-1244
Practice Address - Country:US
Practice Address - Phone:732-658-4662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty