| Queenshade | |
|
245 Snyder St Ste 103 Orange NJ 07050-3707 | |
| (908) 656-4387 | |
| Not Available |
| Full Name | Queenshade |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 245 Snyder St Ste 103, Orange, New Jersey |
| Authorized Official Name and Position | Folashade E Adebiyi (DIRECTOR) |
| Authorized Official Contact | 9086564387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Queenshade 33 Rich St Irvington NJ 07111-2020 Ph: (908) 656-4387 | Queenshade 245 Snyder St Ste 103 Orange NJ 07050-3707 Ph: (908) 656-4387 |
| NPI Number | 1346864212 |
|---|---|
| Provider Enumeration Date | 06/05/2020 |
| Last Update Date | 10/07/2022 |
| Certification Date | 10/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346864212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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