| Public Health Solutions - Fort Greene | |
|
295 Flatbush Avenue Ext Fl 3 Brooklyn NY 11201-3001 | |
| (718) 522-1144 | |
| (646) 619-6696 |
| Full Name | Public Health Solutions - Fort Greene |
|---|---|
| Speciality | Clinic/Center |
| Location | 295 Flatbush Avenue Ext Fl 3, Brooklyn, New York |
| Authorized Official Name and Position | Lisa Davis (PRESIDENT AND CEO) |
| Authorized Official Contact | 6466196400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Public Health Solutions - Fort Greene 40 Worth St Fl 4 New York NY 10013-2904 Ph: (646) 619-6400 | Public Health Solutions - Fort Greene 295 Flatbush Avenue Ext Fl 3 Brooklyn NY 11201-3001 Ph: (718) 522-1144 |
| NPI Number | 1467529529 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 03/30/2023 |
| Medicare PECOS PAC ID | 3476858424 |
|---|---|
| Medicare Enrollment ID | O20160229002128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467529529 | NPI | - | NPPES |
| 02999737 | Medicaid | NY | |
| 02999782 | Medicaid | NY | |
| 00245538 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 7002296R (New York) | Primary |
| Provider Name | Amy Seplin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801316500 PECOS PAC ID: 9436404068 Enrollment ID: I20180621001899 |
| Provider Name | April Lockley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548648538 PECOS PAC ID: 2264712850 Enrollment ID: I20190806002169 |
| Provider Name | Ufeta Tesla Om'iniabohs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184119752 PECOS PAC ID: 2860802543 Enrollment ID: I20201109001767 |
| Provider Name | Anna Larisa Sunderland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154971406 PECOS PAC ID: 5395155881 Enrollment ID: I20201112001586 |
| Provider Name | Janie Nems Johnston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619643905 PECOS PAC ID: 2961800198 Enrollment ID: I20211001001823 |
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