| Laine Np Adult Wellness Care Pc | |
|
539 De Mott Ave North Baldwin NY 11510-1321 | |
| (516) 223-6088 | |
| Not Available |
| Full Name | Laine Np Adult Wellness Care Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 539 De Mott Ave, North Baldwin, New York |
| Authorized Official Name and Position | Rosaire B Laine (CEO) |
| Authorized Official Contact | 9732208313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laine Np Adult Wellness Care Pc 539 De Mott Ave North Baldwin NY 11510-1321 Ph: (516) 223-6088 | Laine Np Adult Wellness Care Pc 539 De Mott Ave North Baldwin NY 11510-1321 Ph: (516) 223-6088 |
| NPI Number | 1225450364 |
|---|---|
| Provider Enumeration Date | 01/08/2014 |
| Last Update Date | 01/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225450364 | NPI | - | NPPES |
| 173000000X | Other | NY | TAXONOMY |
| 0362301 | Medicaid | NJ | |
| 0469 | Medicaid | NY | |
| 1104861558 | Other | NY | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | F304165-1 (New York) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 199824 (New York) | Primary |
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