Exedus Family Healthcare & Wellness Care Services Llc | |
11410 Merrick Blvd Jamaica NY 11434-1335 | |
(718) 233-2972 | |
(667) 771-0892 |
Full Name | Exedus Family Healthcare & Wellness Care Services Llc |
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Speciality | Clinic/Center |
Location | 11410 Merrick Blvd, Jamaica, New York |
Authorized Official Name and Position | Omotunde D Aderin (CEO) |
Authorized Official Contact | 7182332972 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Exedus Family Healthcare & Wellness Care Services Llc 1 Winter Ln Amityville NY 11701-1626 Ph: (917) 653-0577 | Exedus Family Healthcare & Wellness Care Services Llc 11410 Merrick Blvd Jamaica NY 11434-1335 Ph: (718) 233-2972 |
NPI Number | 1023791928 |
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Provider Enumeration Date | 08/08/2023 |
Last Update Date | 02/06/2024 |
Medicare PECOS PAC ID | 1759734031 |
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Medicare Enrollment ID | O20240202001670 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023791928 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Omotunde D Aderin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881248938 PECOS PAC ID: 0244659548 Enrollment ID: I20201006003137 |
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