Healthcare Provider Details

I. General information

NPI: 1316801582
Provider Name (Legal Business Name): MEDNA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BRIDGE PLZ N STE 675
FORT LEE NJ
07024-7112
US

IV. Provider business mailing address

1 BRIDGE PLZ N STE 675
FORT LEE NJ
07024-7112
US

V. Phone/Fax

Practice location:
  • Phone: 917-275-7401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: OGHENEFEJIRO EHWARIEME
Title or Position: PRESIDENT
Credential:
Phone: 917-275-7401