Healthcare Provider Details

I. General information

NPI: 1598452211
Provider Name (Legal Business Name): US MOBILE CHRONIC CARE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 W 14TH ST FL 4
NEW YORK NY
10014-5002
US

IV. Provider business mailing address

14 WALL ST FL 20
NEW YORK NY
10005-2123
US

V. Phone/Fax

Practice location:
  • Phone: 347-298-4100
  • Fax: 347-227-1368
Mailing address:
  • Phone: 347-298-4100
  • Fax: 347-227-1368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONA JANE TAJONERA
Title or Position: PRESIDENT
Credential:
Phone: 347-298-4100