| Mmereole Health | |
|
6101 Kennedy Blvd E Suite 1 West New York NJ 07093-3902 | |
| (714) 366-2581 | |
| Not Available |
| Full Name | Mmereole Health |
|---|---|
| Speciality | Family Medicine |
| Location | 6101 Kennedy Blvd E, West New York, New Jersey |
| Authorized Official Name and Position | Paulina Mmereole (NURSE PRACTITIONER) |
| Authorized Official Contact | 7143662581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmereole Health 6101 Kennedy Blvd E West New York NJ 07093-3902 Ph: (714) 366-2581 | Mmereole Health 6101 Kennedy Blvd E Suite 1 West New York NJ 07093-3902 Ph: (714) 366-2581 |
| NPI Number | 1588105910 |
|---|---|
| Provider Enumeration Date | 03/18/2017 |
| Last Update Date | 03/18/2017 |
| Medicare PECOS PAC ID | 5496022360 |
|---|---|
| Medicare Enrollment ID | O20170524001684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588105910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA09692300 (New Jersey) | Primary |
| 363LP0200X | Nurse Practitioner - Pediatrics | 26NJ00504700 (New Jersey) | Secondary |
| Provider Name | Paulina Mmereole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083029656 PECOS PAC ID: 1254550940 Enrollment ID: I20140911000138 |
| Provider Name | Robert Uzodimma Mmereole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669615308 PECOS PAC ID: 7113189507 Enrollment ID: I20160504000254 |
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