| Consolidated Care Llc | |
|
410 Chancellor Ave Newark NJ 07112-1030 | |
| (862) 246-7899 | |
| Not Available |
| Full Name | Consolidated Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 410 Chancellor Ave, Newark, New Jersey |
| Authorized Official Name and Position | Ebere Diribe (APN) |
| Authorized Official Contact | 9737358531 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Consolidated Care Llc 410 Chancellor Ave Newark NJ 07112-1030 Ph: (862) 246-7899 | Consolidated Care Llc 410 Chancellor Ave Newark NJ 07112-1030 Ph: (862) 246-7899 |
| NPI Number | 1336538305 |
|---|---|
| Provider Enumeration Date | 01/14/2015 |
| Last Update Date | 07/13/2016 |
| Medicare PECOS PAC ID | 3779809405 |
|---|---|
| Medicare Enrollment ID | O20150224000780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336538305 | NPI | - | NPPES |
| 0424048 | Other | NJ | MEDICARE |
| Provider Name | Homer L Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578667044 PECOS PAC ID: 1153371521 Enrollment ID: I20050125000272 |
| Provider Name | Ebere Diribe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831320258 PECOS PAC ID: 7719107168 Enrollment ID: I20141007000154 |
| Provider Name | Mariam I Garuba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275748261 PECOS PAC ID: 1759536576 Enrollment ID: I20180710000211 |
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