| Exodus Clinic Llc | |
|
671 State Route 17m Monroe NY 10950-3318 | |
| (845) 837-1635 | |
| (845) 837-1634 |
| Full Name | Exodus Clinic Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 671 State Route 17m, Monroe, New York |
| Authorized Official Name and Position | Olanrewaju Somorin (CEO) |
| Authorized Official Contact | 8458371635 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Exodus Clinic Llc Po Box 4124 Middletown NY 10941-8124 Ph: (845) 837-1635 | Exodus Clinic Llc 671 State Route 17m Monroe NY 10950-3318 Ph: (845) 837-1635 |
| NPI Number | 1689988149 |
|---|---|
| Provider Enumeration Date | 07/27/2010 |
| Last Update Date | 07/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689988149 | NPI | - | NPPES |
| #2008-144 | Other | NY | OASAS APPLICATION CERTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (New York) | Primary |
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