| Rise Group Care Pc | |
|
8 Lombardy St Ste 110 Newark NJ 07102-3210 | |
| (201) 500-9755 | |
| Not Available |
| Full Name | Rise Group Care Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8 Lombardy St Ste 110, Newark, New Jersey |
| Authorized Official Name and Position | Sangeet Khanna (PROVIDER) |
| Authorized Official Contact | 3472784567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rise Group Care Pc 8 Lombardy St Ste 110 Newark NJ 07102-3210 Ph: () - | Rise Group Care Pc 8 Lombardy St Ste 110 Newark NJ 07102-3210 Ph: (201) 500-9755 |
| NPI Number | 1184389389 |
|---|---|
| Provider Enumeration Date | 11/02/2021 |
| Last Update Date | 06/14/2024 |
| Certification Date | 06/14/2024 |
| Medicare PECOS PAC ID | 9638568215 |
|---|---|
| Medicare Enrollment ID | O20211122000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184389389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Sangeet Khanna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225298896 PECOS PAC ID: 6204992761 Enrollment ID: I20090804000237 |
| Provider Name | Olukayode Agunbiade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033506787 PECOS PAC ID: 8325435431 Enrollment ID: I20220420000405 |
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