| Your Neighborhood Clinic Llc | |
|
454 Morris Ave Springfield NJ 07081-1158 | |
| (908) 312-0288 | |
| Not Available |
| Full Name | Your Neighborhood Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 454 Morris Ave, Springfield, New Jersey |
| Authorized Official Name and Position | Mary Odusanya (APN) |
| Authorized Official Contact | 9083120288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Neighborhood Clinic Llc 454 Morris Ave Springfield NJ 07081-1158 Ph: (908) 312-0288 | Your Neighborhood Clinic Llc 454 Morris Ave Springfield NJ 07081-1158 Ph: (908) 312-0288 |
| NPI Number | 1407424021 |
|---|---|
| Provider Enumeration Date | 06/11/2021 |
| Last Update Date | 06/11/2021 |
| Medicare PECOS PAC ID | 4385047943 |
|---|---|
| Medicare Enrollment ID | O20210721000122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407424021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mary Odusanya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346770575 PECOS PAC ID: 8628349842 Enrollment ID: I20170807002755 |
| Provider Name | Francois Nguetsop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013430065 PECOS PAC ID: 0941569354 Enrollment ID: I20180110002394 |
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