| St Remi Llc | |
|
822 Klemm Ave Gloucester City NJ 08030-1627 | |
| (856) 282-5566 | |
| (856) 396-9917 |
| Full Name | St Remi Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 822 Klemm Ave, Gloucester City, New Jersey |
| Authorized Official Name and Position | Isiaka Abayomi Bolarinwa (PRESIDENT/ MEDICAL DIRECTOR) |
| Authorized Official Contact | 8562825566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Remi Llc 822 Klemm Ave Gloucester City NJ 08030-1627 Ph: (856) 282-5566 | St Remi Llc 822 Klemm Ave Gloucester City NJ 08030-1627 Ph: (856) 282-5566 |
| NPI Number | 1144583519 |
|---|---|
| Provider Enumeration Date | 06/20/2012 |
| Last Update Date | 03/14/2023 |
| Certification Date | 03/14/2023 |
| Medicare PECOS PAC ID | 0042456683 |
|---|---|
| Medicare Enrollment ID | O20130426000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144583519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | MA072697 (New Jersey) | Primary |
| Provider Name | Barbara M Wren |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1275506107 PECOS PAC ID: 2961492285 Enrollment ID: I20040517001324 |
| Provider Name | Isiaka A Bolarinwa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467403196 PECOS PAC ID: 3779478524 Enrollment ID: I20050909000014 |
| Provider Name | Mirel Adler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356831044 PECOS PAC ID: 6103181250 Enrollment ID: I20180521001888 |
| Provider Name | Bolaji O Bolarinwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104476381 PECOS PAC ID: 1759715147 Enrollment ID: I20191217002778 |
| Provider Name | Folawewo A Ajayi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922632520 PECOS PAC ID: 5092138966 Enrollment ID: I20200710000780 |
| Provider Name | Ngozi Rita Okafor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699490243 PECOS PAC ID: 5395116362 Enrollment ID: I20230131000020 |
| Provider Name | Olubukunola Odeyemi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528790060 PECOS PAC ID: 2365896917 Enrollment ID: I20230929002665 |
My Father's House, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Po Box 230, Gloucester City, NJ 08030 Phone: 856-742-0900 Fax: 856-742-0900 |