| Grace Medical Care | |
|
422 Grand St # 9-10 Hoboken NJ 07030-2727 | |
| (908) 693-5036 | |
| (862) 849-2319 |
| Full Name | Grace Medical Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 422 Grand St # 9-10, Hoboken, New Jersey |
| Authorized Official Name and Position | Adewale Adefowoju (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9086935036 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Medical Care 1379 Brookfall Ave Union NJ 07083-7013 Ph: (908) 693-5036 | Grace Medical Care 422 Grand St # 9-10 Hoboken NJ 07030-2727 Ph: (908) 693-5036 |
| NPI Number | 1881217685 |
|---|---|
| Provider Enumeration Date | 05/27/2020 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Medicare PECOS PAC ID | 8921426164 |
|---|---|
| Medicare Enrollment ID | O20200921000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881217685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Barbara Bousi Njuguna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235638230 PECOS PAC ID: 3173886561 Enrollment ID: I20180822001044 |
| Provider Name | Femi Omidire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235760984 PECOS PAC ID: 1153744602 Enrollment ID: I20200701000600 |
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