MEDICARE: EXCLUSIVE HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1679452148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCLUSIVE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	2816 MORRIS AVE STE 20B
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-4849
Country	:	US
Telephone Number	:	973-339-3181
Fax Number	:	973-339-3182

Provider Business Practice Location Address
First Line	:	2816 MORRIS AVE # 20B
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-4849
Country	:	US
Telephone Number	:	973-339-3181
Fax Number	:	973-339-3182

Authorized Official
Title or Position	:	OWNER
Name	:	MS. BERGENIE CELONY
Credential	:	APN
Telephone Number	:	973-814-1278

Provider Enumeration Date	:	08/29/2025
Last Update Date	:	10/04/2025

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