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General NPI Number Information
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NPI Number | 1861216293
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Entity Type | Organization
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Legal Business Name | NEW ERA CLINIC LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 695 HANOVER PIKE UNIT H
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City | HAMPSTEAD
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State | MD
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Zip | 21074-2015
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Country | US
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Telephone | 301-404-9354
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Fax |
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Provider Business Mailing Address
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Address Line | 770 BLUE MOON LN
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City | WESTMINSTER
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State | MD
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Zip | 21157-6878
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Country | US
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Telephone | 301-404-9354
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | OLAPEJU ODU
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Credential |
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Telephone | 301-404-9354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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