Green Oak Professional Health Services | |
120 Millburn Ave Ste 201 Millburn NJ 07041-1935 | |
(973) 392-0217 | |
Not Available |
Full Name | Green Oak Professional Health Services |
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Speciality | Clinic/Center |
Location | 120 Millburn Ave Ste 201, Millburn, New Jersey |
Authorized Official Name and Position | Kazeem Alao Olajide (PRESIDENT) |
Authorized Official Contact | 9733920217 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Green Oak Professional Health Services 735 S 12th St Newark NJ 07103-1740 Ph: () - | Green Oak Professional Health Services 120 Millburn Ave Ste 201 Millburn NJ 07041-1935 Ph: (973) 392-0217 |
NPI Number | 1649825944 |
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Provider Enumeration Date | 08/05/2019 |
Last Update Date | 09/06/2019 |
Medicare PECOS PAC ID | 3779814215 |
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Medicare Enrollment ID | O20191014002639 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649825944 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Kazeem A Olajide |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184110165 PECOS PAC ID: 6002169620 Enrollment ID: I20181030000514 |
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