Provider Demographics
NPI:1336794759
Name:CONTINUUM HEALTH MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:CONTINUUM HEALTH MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:OKERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-237-0081
Mailing Address - Street 1:2244 PALISADES CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-6402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2244 PALISADES CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-6402
Practice Address - Country:US
Practice Address - Phone:845-358-2433
Practice Address - Fax:845-358-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-02
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY019997539Medicaid