| Mercy Health And Wellness, Llc | |
|
47 Ernest Street Nutley NJ 07110 | |
| (732) 771-9001 | |
| Not Available |
| Full Name | Mercy Health And Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 47 Ernest Street, Nutley, New Jersey |
| Authorized Official Name and Position | Odette Chantal Tiomo (NURSE PRACTITIONER) |
| Authorized Official Contact | 7327719001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Health And Wellness, Llc 56m Reading Rd Edison NJ 08817-2183 Ph: (513) 828-2120 | Mercy Health And Wellness, Llc 47 Ernest Street Nutley NJ 07110 Ph: (732) 771-9001 |
| NPI Number | 1356180442 |
|---|---|
| Provider Enumeration Date | 05/20/2024 |
| Last Update Date | 07/19/2024 |
| Certification Date | 07/19/2024 |
| Medicare PECOS PAC ID | 6507399888 |
|---|---|
| Medicare Enrollment ID | O20241024002697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356180442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Odette C Tiomo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538578380 PECOS PAC ID: 9335465541 Enrollment ID: I20150306000479 |
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