| Np Xperience Llc | |
|
21 Angela Dr Ste 202 Old Bridge NJ 08857 | |
| (732) 908-4522 | |
| Not Available |
| Full Name | Np Xperience Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 21 Angela Dr, Old Bridge, New Jersey |
| Authorized Official Name and Position | Candice Robertson (OWNER/NP) |
| Authorized Official Contact | 7329084522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Np Xperience Llc 21 Angela Dr Ste 202 Old Bridge NJ 08857 Ph: (732) 908-4522 | Np Xperience Llc 21 Angela Dr Ste 202 Old Bridge NJ 08857 Ph: (732) 908-4522 |
| NPI Number | 1225774367 |
|---|---|
| Provider Enumeration Date | 05/11/2022 |
| Last Update Date | 06/30/2022 |
| Medicare PECOS PAC ID | 0042678484 |
|---|---|
| Medicare Enrollment ID | O20230616002041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225774367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mitesh K Patel |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1093987034 PECOS PAC ID: 8123213097 Enrollment ID: I20101117000928 |
| Provider Name | Shontal Raffington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467826065 PECOS PAC ID: 1052612835 Enrollment ID: I20151221001649 |
| Provider Name | Candice Yvette Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083157291 PECOS PAC ID: 0749564771 Enrollment ID: I20170310001193 |
| Provider Name | Keydella Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053855809 PECOS PAC ID: 8123303047 Enrollment ID: I20170316000114 |
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