| Primerose Medical P.C. | |
|
11 Bench Ln Levittown NY 11756-1802 | |
| (718) 795-8272 | |
| Not Available |
| Full Name | Primerose Medical P.C. |
|---|---|
| Speciality | Clinic/Center |
| Location | 11 Bench Ln, Levittown, New York |
| Authorized Official Name and Position | Olubunmi Abiye Bolaji (OWNER) |
| Authorized Official Contact | 7187958272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primerose Medical P.C. 11 Bench Ln Levittown NY 11756-1802 Ph: (718) 795-8272 | Primerose Medical P.C. 11 Bench Ln Levittown NY 11756-1802 Ph: (718) 795-8272 |
| NPI Number | 1699103721 |
|---|---|
| Provider Enumeration Date | 10/29/2013 |
| Last Update Date | 10/29/2013 |
| Medicare PECOS PAC ID | 7315162260 |
|---|---|
| Medicare Enrollment ID | O20140709000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699103721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 254613 (New York) | Primary |
| Provider Name | Olubunmi Bolaji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619100633 PECOS PAC ID: 8325170574 Enrollment ID: I20100723000178 |
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