| Exedus Family Healthcare & Wellness Care Services Llc | |
|
11410 Merrick Blvd Jamaica NY 11434-1335 | |
| (718) 233-2972 | |
| (667) 771-0892 |
| Full Name | Exedus Family Healthcare & Wellness Care Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11410 Merrick Blvd, Jamaica, New York |
| Authorized Official Name and Position | Omotunde D Aderin (CEO) |
| Authorized Official Contact | 7182332972 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Exedus Family Healthcare & Wellness Care Services Llc 1 Winter Ln Amityville NY 11701-1626 Ph: (917) 653-0577 | Exedus Family Healthcare & Wellness Care Services Llc 11410 Merrick Blvd Jamaica NY 11434-1335 Ph: (718) 233-2972 |
| NPI Number | 1023791928 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 02/06/2024 |
| Medicare PECOS PAC ID | 1759734031 |
|---|---|
| Medicare Enrollment ID | O20240202001670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023791928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Omotunde D Aderin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881248938 PECOS PAC ID: 0244659548 Enrollment ID: I20201006003137 |
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