| Family First Nurse Practitioner In Family Health Pc | |
|
11156 76th Dr Ste Ul1 Forest Hills NY 11375-7029 | |
| (347) 356-4434 | |
| (973) 779-1696 |
| Full Name | Family First Nurse Practitioner In Family Health Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11156 76th Dr Ste Ul1, Forest Hills, New York |
| Authorized Official Name and Position | Omolara Olaniyi (OWNER) |
| Authorized Official Contact | 3473564434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family First Nurse Practitioner In Family Health Pc 11156 76th Dr Ste Ul1 Forest Hills NY 11375-7029 Ph: (347) 356-4434 | Family First Nurse Practitioner In Family Health Pc 11156 76th Dr Ste Ul1 Forest Hills NY 11375-7029 Ph: (347) 356-4434 |
| NPI Number | 1598133399 |
|---|---|
| Provider Enumeration Date | 09/10/2015 |
| Last Update Date | 04/10/2018 |
| Medicare PECOS PAC ID | 7810251832 |
|---|---|
| Medicare Enrollment ID | O20180427001341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598133399 | NPI | - | NPPES |
| 1023275575 | Other | NY | HIPPA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | F333974-1 (New York) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Omolara A Olaniyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023275575 PECOS PAC ID: 8729342746 Enrollment ID: I20180427001554 |
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