C-line Community Outreach Services | |
110 Martin Luther King Jr Dr Jersey City NJ 07305-3168 | |
(201) 200-1965 | |
(201) 200-1826 |
Full Name | C-line Community Outreach Services |
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Speciality | Clinic/Center |
Location | 110 Martin Luther King Jr Dr, Jersey City, New Jersey |
Authorized Official Name and Position | Caroline Nelson (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2012001965 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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C-line Community Outreach Services Po Box 15802 Jersey City NJ 07305-0802 Ph: (201) 200-1965 | C-line Community Outreach Services 110 Martin Luther King Jr Dr Jersey City NJ 07305-3168 Ph: (201) 200-1965 |
NPI Number | 1336431675 |
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Provider Enumeration Date | 05/04/2011 |
Last Update Date | 05/21/2014 |
Medicare PECOS PAC ID | 4587826383 |
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Medicare Enrollment ID | O20120424000081 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336431675 | NPI | - | NPPES |
0352233 | Medicaid | NJ |
Provider Name | Vivian J Posada |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356690093 PECOS PAC ID: 7315168796 Enrollment ID: I20180521002953 |
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