DIVINE MEDICAL LLC (NPI# 1952920795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952920795 |
| Entity Type | Organization |
| Organization Name | DIVINE MEDICAL LLC |
| Practice Address |
13163 233rd St # 1 Rosedale NY 11422-1305 |
| Practice Telephone | 7185253347 |
| Enumeration Date | 2020-04-12 |
| Last Update Date | 2020-04-12 |
| Authorized Official Name | DR. AUGUSTINE UMEOZOR (CEO/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9177422442 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02208982 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | DIVINE MEDICAL LLC | 1013 Centre Road, Ste 403a, Wilmington, De 19805 |
| Street Address |
13163 233RD ST # 1 |
| City | ROSEDALE |
| State | NY |
| Zip Code | 11422-1305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447791116 | Home Companion Services,inc. | In Home Supportive Care | 25311 147th Dr, Rosedale, NY 11422 | 2017-03-15 |
| 1508302779 | Rayne Shomo | Licensed Practical Nurse | 249-22 144th Ave, Rosedale, NY 11422 | 2017-01-12 |
| 1194277491 | Kettely Francois | Nurse Practitioner | 149-86 253 Rd Street, Rosedale, NY 11422 | 2016-11-03 |
| 1578019410 | Maureen Mckenzie | Registered Nurse | 241-25 148th Drive, Rosedale, NY 11422 | 2016-08-31 |
| 1386097657 | A Touch That Cares Home Services | Home Health | 13891 Francis Lewis Blvd, Rosedale, NY 11422 | 2016-07-21 |
| 1093160293 | Regine St. Leger | Registered Nurse | 128-07 236th Street, Rosedale, NY 11422 | 2016-04-26 |
| 1942664115 | Raising In The Sun, Ltd | Early Intervention Provider Agency | 257-04 149th Avenue, Rosedale, NY 11422 | 2016-04-13 |
| 1740656958 | Jaelle Jeudy | Licensed Practical Nurse | 243-59 Mayda Rd, Rosedale, NY 11422 | 2015-08-12 |
| 1851785380 | Elizabeth Madison Nutrition, Pllc | Clinic/Center | 13333 Brookville Boulevard, Suite 229c, Rosedale, NY 11422 | 2015-03-23 |
| 1659763894 | Leonard Barrett | Nutritionist | 220 01 Jamaica Av., Queens, NY 11422 | 2015-02-25 |
| Find all providers in zip 11422 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1154988897 | Bissalam Medical LLC | Clinic/Center | 3391 3rd Ave Ste 1, Bronx, NY 10456-5355 | 2019-05-28 |
| 1851859961 | Lower Westchester Medical Associates, P.C. | Clinic/Center | 105 Stevens Ave Ste 305306, Mount Vernon, NY 10550-2686 | 2019-03-07 |
| 1659849115 | Plc Optical Corp | Clinic/Center | 460 County Road 111 Unit 8, Manorville, NY 11949-3375 | 2018-11-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.