Your Neighborhood Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

YOUR NEIGHBORHOOD CLINIC LLC

Practice address

454 Morris Ave
Springfield, NJ 07081-1158

Phone

(908) 312-0288

NPI assigned

Jun 11, 2021

Last updated

Jun 11, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Odusanya, APNNPI 1346770575

Title

Apn

Phone

(908) 312-0288

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Odusanya

  • Family Nurse Practitioner
  • Springfield, NJ
  • NPI 1346770575
  Medicare reassignment NPD Authorized official
• Francois Joseph Nguetsop

  • Psychiatric/Mental Health Nurse Practitioner
  • Bridgewater, NJ
  • NPI 1013430065
  Medicare reassignment NPD
• Chanel T. Tillery, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Newark, NJ
  • NPI 1083463657
  Medicare reassignment NPD
• Carol Irving, MD

  • Emergency Medicine Physician
  • East Hanover, NJ
  • NPI 1457340788
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1407424021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811158",
            "telephone_number": "908-312-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811158",
            "telephone_number": "908-312-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR NEIGHBORHOOD CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "ODUSANYA",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "APN",
        "authorized_official_telephone_number": "908-312-0288",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Wulach, MD
• Agnieszka Maria Wydra
• Maria Milagros Yambao, DDS
• Kathleen A Yemm, LCSW
• Sara Amy Youner, L.AC
• Uzma Zafar, MD
• Uzma Zaidi, PA-C
• Yuliya Zalavskiy
• Jerrold R Zeitels, MD
• Binghua Zhu, MD

• Primary Care Clinic/Center in Springfield, NJ
• Providers in Springfield, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.