| Madeorakouma Bahomda, MS | |
|
650 Park Ave Apt 206, East Orange, NJ 07017-1578 | |
| (973) 789-4037 | |
| Not Available |
| Full Name | Madeorakouma Bahomda |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 650 Park Ave Apt 206, East Orange, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538993662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 37PC00961800 (New Jersey) | Primary |
| Entity Name | Valera Medical, P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306435060 PECOS PAC ID: 6709272008 Enrollment ID: O20220414000699 |
| Mailing Address | Practice Location Address |
|---|---|
| Madeorakouma Bahomda, MS 650 Park Ave Apt 206, East Orange, NJ 07017-1578 Ph: (973) 789-4037 | Madeorakouma Bahomda, MS 650 Park Ave Apt 206, East Orange, NJ 07017-1578 Ph: (973) 789-4037 |
Thomas Johnson Sr., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 220 S Harrison St, East Orange, NJ 07018 Phone: 973-677-7053 | |
Ramonita Bracy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Glenwood Ave Ste 101, East Orange, NJ 07017 Phone: 973-675-3817 | |
Mr. Marc Wurgaft, L.C.S.W. Counselor Medicare: Not Enrolled in Medicare Practice Location: 60 Evergreen Pl, Suite 309, East Orange, NJ 07018 Phone: 973-854-3652 Fax: 973-854-3653 | |
Ms. Rosario Reveron, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Glenwood Ave Ste 101, East Orange, NJ 07017 Phone: 973-675-3817 | |
Shaniqua Gayle, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 385 Tremont Ave, East Orange, NJ 07018 Phone: 973-454-0552 | |
Yesse Alexandra Puello, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Glenwood Ave Ste 106, East Orange, NJ 07017 Phone: 201-306-3549 | |
Sasha Branch, LCADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 46 Park Pl, East Orange, NJ 07017 Phone: 973-310-5146 |