| 180 Degrees Medical Pllc | |
|
620 Malcolm X Blvd Apt 11d New York NY 10037-1206 | |
| (251) 599-2388 | |
| Not Available |
| Full Name | 180 Degrees Medical Pllc |
|---|---|
| Speciality | Preventive Medicine |
| Location | 620 Malcolm X Blvd Apt 11d, New York, New York |
| Authorized Official Name and Position | Tremaine Jamar Wright (OWNER) |
| Authorized Official Contact | 2515992388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 180 Degrees Medical Pllc 620 Malcolm X Blvd Apt 11d New York NY 10037-1206 Ph: () - | 180 Degrees Medical Pllc 620 Malcolm X Blvd Apt 11d New York NY 10037-1206 Ph: (251) 599-2388 |
| NPI Number | 1225736705 |
|---|---|
| Provider Enumeration Date | 02/23/2023 |
| Last Update Date | 09/26/2023 |
| Medicare PECOS PAC ID | 7810358819 |
|---|---|
| Medicare Enrollment ID | O20230807001045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225736705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 2083B0002X | Preventive Medicine - Obesity Medicine | (* (Not Available)) | Primary |
| Provider Name | Tremaine Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093247926 PECOS PAC ID: 2961897798 Enrollment ID: I20220315000568 |
| Provider Name | Jennifer Wells Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356079636 PECOS PAC ID: 3072968098 Enrollment ID: I20231011003384 |
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