| Newark Dept Of Health & Community Wellness- Bc | |
|
30 N Munn Ave # 30a Newark NJ 07106-1411 | |
| (973) 877-6111 | |
| Not Available |
| Full Name | Newark Dept Of Health & Community Wellness- Bc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 30 N Munn Ave # 30a, Newark, New Jersey |
| Authorized Official Name and Position | Oluyinka Fadahunsi (FINANCIAL OPERATIONS OFFICER) |
| Authorized Official Contact | 9737337558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Newark Dept Of Health & Community Wellness- Bc 30 N Munn Ave # 30a Newark NJ 07106-1411 Ph: (973) 877-6111 | Newark Dept Of Health & Community Wellness- Bc 30 N Munn Ave # 30a Newark NJ 07106-1411 Ph: (973) 877-6111 |
| NPI Number | 1477914612 |
|---|---|
| Provider Enumeration Date | 03/16/2016 |
| Last Update Date | 03/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477914612 | NPI | - | NPPES |
| 0390739 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 24765 (New Jersey) | Primary |
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