| Luchiee LLC | |
|
454 Morris Ave Springfield NJ 07081-1158 | |
| (908) 922-1727 | |
| Not Available |
| Full Name | Luchiee LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 454 Morris Ave, Springfield, New Jersey |
| Authorized Official Name and Position | Oluchi Chilaka (NP) |
| Authorized Official Contact | 9089221727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luchiee LLC 5 Hemlock Ter Springfield NJ 07081-2405 Ph: (908) 922-1727 | Luchiee LLC 454 Morris Ave Springfield NJ 07081-1158 Ph: (908) 922-1727 |
| NPI Number | 1124694781 |
|---|---|
| Provider Enumeration Date | 06/02/2021 |
| Last Update Date | 06/02/2021 |
| Certification Date | 06/02/2021 |
| Medicare PECOS PAC ID | 4486052172 |
|---|---|
| Medicare Enrollment ID | O20211011001770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124694781 | NPI | - | NPPES |
| 1336651520 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | () | Primary |
| Provider Name | Oluchi Chilaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336651520 PECOS PAC ID: 3274893391 Enrollment ID: I20180212000987 |
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