Exodus Clinic Llc

LBN: Exodus Clinic Llc
Exodus Clinic Llc is an health care organization with primary practice located at 671 State Route 17M , Monroe NY 10950-3318. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Exodus Clinic Llc can be contacted via phone (845) 837-1635, or through Somorin, Olanrewaju via phone (845) 837-1635.

Contact Information

Primary practice address
671 State Route 17M Monroe NY 10950-3318
Phone: (845) 837-1635
Fax: (845) 837-1634
Website:
Map and Directions
Authorized official contact:
Name: Somorin, Olanrewaju Doctor of Medicine (MD)
Phone: (845) 837-1635

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X New York

Profile Details

NPI number 1689988149
LBN Legal business name Exodus Clinic Llc
DBA Doing business as
Authorized official Somorin, Olanrewaju Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 27th, 2010
Last updated Jul 27th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689988149 NPPES
New York Other #2008-144 OASAS APPLICATION CERTIFICATION

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