| Nissi Iv Hydration Therapy And Wellness Clinic Llc | |
|
15 W Prospect St Ste 3 East Brunswick NJ 08816-2161 | |
| (732) 301-4465 | |
| Not Available |
| Full Name | Nissi Iv Hydration Therapy And Wellness Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 15 W Prospect St Ste 3, East Brunswick, New Jersey |
| Authorized Official Name and Position | Amanda Adiyia (OWNER,ADMINISTRATOR) |
| Authorized Official Contact | 7323014465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nissi Iv Hydration Therapy And Wellness Clinic Llc 33 Goldstar Dr Princeton NJ 08540-8578 Ph: (732) 301-4465 | Nissi Iv Hydration Therapy And Wellness Clinic Llc 15 W Prospect St Ste 3 East Brunswick NJ 08816-2161 Ph: (732) 301-4465 |
| NPI Number | 1245005669 |
|---|---|
| Provider Enumeration Date | 11/15/2023 |
| Last Update Date | 11/15/2023 |
| Medicare PECOS PAC ID | 3173968658 |
|---|---|
| Medicare Enrollment ID | O20240226000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245005669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Amanda Adiyia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295339398 PECOS PAC ID: 2365858164 Enrollment ID: I20210302002137 |
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