Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Medical Weight Loss of New York, PLLC

Organization Obesity Medicine (Family Medicine) Physician · NPI 1174940696

Medical Weight Loss of New York, PLLC is an Obesity Medicine (Family Medicine) Physician in Fayetteville, New York. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

6800 E Genesee St Ste 1501
Fayetteville, NY 13066-1089
Phone: (315) 391-9390
Fax: (315) 445-0056
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obesity Medicine (Family Medicine) Physician (primary) Taxonomy 207QB0002X
Obesity Medicine (Internal Medicine) Physician Taxonomy 207RB0002X

Record details

NPI number1174940696
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bryan Wendel — Practice Manager · (315) 445-0003
NPI enumeratedMarch 21, 2014
Last updated in NPPESMarch 21, 2014
Mailing address6800 E Genesee St, Suite 1501, Fayetteville, NY 13066-1089