| Mastermind Healthcare, Llc | |
|
1925 Pacific Ave Wellness Pavillion 5th Floor Atlantic City NJ 08401 | |
| (609) 910-4500 | |
| (732) 693-1214 |
| Full Name | Mastermind Healthcare, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1925 Pacific Ave, Atlantic City, New Jersey |
| Authorized Official Name and Position | Ezinne U Nwotite (PROVIDER) |
| Authorized Official Contact | 6097484199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mastermind Healthcare, Llc Po Box 161 Linwood NJ 08221-0161 Ph: (609) 365-8120 | Mastermind Healthcare, Llc 1925 Pacific Ave Wellness Pavillion 5th Floor Atlantic City NJ 08401 Ph: (609) 910-4500 |
| NPI Number | 1225798044 |
|---|---|
| Provider Enumeration Date | 12/20/2021 |
| Last Update Date | 12/20/2021 |
| Medicare PECOS PAC ID | 4486048873 |
|---|---|
| Medicare Enrollment ID | O20220301001027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225798044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mary N Onwuka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649290636 PECOS PAC ID: 0244142867 Enrollment ID: I20031103000412 |
| Provider Name | Qi Sun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518063049 PECOS PAC ID: 1153399415 Enrollment ID: I20040923000855 |
| Provider Name | Manoj P Jain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972717676 PECOS PAC ID: 4981789476 Enrollment ID: I20100329000760 |
| Provider Name | Ezinne U Nwotite |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457662603 PECOS PAC ID: 8527183177 Enrollment ID: I20100920000412 |
| Provider Name | Naseer Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982062667 PECOS PAC ID: 2769779073 Enrollment ID: I20160929000873 |
| Provider Name | Urmil N Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386132603 PECOS PAC ID: 0648674879 Enrollment ID: I20210810001023 |
| Provider Name | Kazi Z Beagum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245974641 PECOS PAC ID: 7618355488 Enrollment ID: I20220607001601 |
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