| Intelecare, Llc. | |
|
134 Coburn Ln Somerset NJ 08873-4769 | |
| (908) 636-3613 | |
| (908) 636-3613 |
| Full Name | Intelecare, Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 134 Coburn Ln, Somerset, New Jersey |
| Authorized Official Name and Position | Mona Lisa Hinds (APN, OWNER) |
| Authorized Official Contact | 9086363613 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intelecare, Llc. 134 Coburn Ln Somerset NJ 08873-4769 Ph: (908) 636-3613 | Intelecare, Llc. 134 Coburn Ln Somerset NJ 08873-4769 Ph: (908) 636-3613 |
| NPI Number | 1285152363 |
|---|---|
| Provider Enumeration Date | 09/08/2017 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 6002176351 |
|---|---|
| Medicare Enrollment ID | O20180205002295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285152363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 26NJ00597900 (New Jersey) | Primary |
| 261QH0100X | Clinic/center - Health Service | 26NJ00597900 (New Jersey) | Secondary |
| Provider Name | Virginia Atieh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659778306 PECOS PAC ID: 9436472131 Enrollment ID: I20150105002107 |
| Provider Name | Mona Lisa Abankwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902184138 PECOS PAC ID: 0244510212 Enrollment ID: I20161208001254 |
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