| Onecare Health-advanced Practice Health & Wellness Corp | |
|
97 Port Richmond Ave Staten Island NY 10302-1306 | |
| (347) 460-1239 | |
| Not Available |
| Full Name | Onecare Health-advanced Practice Health & Wellness Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 97 Port Richmond Ave, Staten Island, New York |
| Authorized Official Name and Position | Carlos M Barrera (CEO) |
| Authorized Official Contact | 3474601239 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Onecare Health-advanced Practice Health & Wellness Corp 97 Port Richmond Ave Staten Island NY 10302-1306 Ph: (347) 460-1239 | Onecare Health-advanced Practice Health & Wellness Corp 97 Port Richmond Ave Staten Island NY 10302-1306 Ph: (347) 460-1239 |
| NPI Number | 1013677053 |
|---|---|
| Provider Enumeration Date | 12/17/2021 |
| Last Update Date | 12/17/2021 |
| Medicare PECOS PAC ID | 4587056072 |
|---|---|
| Medicare Enrollment ID | O20220112002596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013677053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Mark Watson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043263247 PECOS PAC ID: 2264488477 Enrollment ID: I20051205000834 |
| Provider Name | Timothy A Aldrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194212522 PECOS PAC ID: 5193151934 Enrollment ID: I20200214000374 |
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