Primerose Medical P.c. | |
11 Bench Ln Levittown NY 11756-1802 | |
(718) 795-8272 | |
Not Available |
Full Name | Primerose Medical P.c. |
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Speciality | Clinic/Center |
Location | 11 Bench Ln, Levittown, New York |
Authorized Official Name and Position | Olubunmi Abiye Bolaji (OWNER) |
Authorized Official Contact | 7187958272 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primerose Medical P.c. 11 Bench Ln Levittown NY 11756-1802 Ph: (718) 795-8272 | Primerose Medical P.c. 11 Bench Ln Levittown NY 11756-1802 Ph: (718) 795-8272 |
NPI Number | 1699103721 |
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Provider Enumeration Date | 10/29/2013 |
Last Update Date | 10/29/2013 |
Medicare PECOS PAC ID | 7315162260 |
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Medicare Enrollment ID | O20140709000090 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699103721 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 254613 (New York) | Primary |
Provider Name | Olubunmi Bolaji |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619100633 PECOS PAC ID: 8325170574 Enrollment ID: I20100723000178 |
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