| Eterra Health PC | |
|
158 Linwood Plz Ste 307 Fort Lee NJ 07024-3761 | |
| (848) 305-9934 | |
| (432) 277-8130 |
| Full Name | Eterra Health PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 158 Linwood Plz Ste 307, Fort Lee, New Jersey |
| Authorized Official Name and Position | Hyerim Jeon (OWNER) |
| Authorized Official Contact | 3474034254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eterra Health PC 45 E Edsall Ave # 1 Palisades Park NJ 07650-1420 Ph: (848) 305-9934 | Eterra Health PC 158 Linwood Plz Ste 307 Fort Lee NJ 07024-3761 Ph: (848) 305-9934 |
| NPI Number | 1699649806 |
|---|---|
| Provider Enumeration Date | 10/01/2025 |
| Last Update Date | 10/01/2025 |
| Certification Date | 10/01/2025 |
| Medicare PECOS PAC ID | 6103304290 |
|---|---|
| Medicare Enrollment ID | O20260130000061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699649806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| Provider Name | Hyerim Jeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699326009 PECOS PAC ID: 5890122790 Enrollment ID: I20260130000115 |
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