| Optimum Family Medicine P.c | |
|
675 Nereid Ave Bronx NY 10470-1514 | |
| (347) 202-9545 | |
| (347) 202-9580 |
| Full Name | Optimum Family Medicine P.c |
|---|---|
| Speciality | Clinic/Center |
| Location | 675 Nereid Ave, Bronx, New York |
| Authorized Official Name and Position | Olufunmilayo O Adeyanju (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3472029545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Family Medicine P.c 675 Nereid Ave Bronx NY 10470-1514 Ph: (347) 202-9545 | Optimum Family Medicine P.c 675 Nereid Ave Bronx NY 10470-1514 Ph: (347) 202-9545 |
| NPI Number | 1609952043 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4284631508 |
|---|---|
| Medicare Enrollment ID | O20061030000625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609952043 | NPI | - | NPPES |
| 02797726 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 236764 (New York) | Primary |
| Provider Name | Olufunmilayo O Adeyanju |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689613564 PECOS PAC ID: 5991722548 Enrollment ID: I20061030000618 |
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