Organization
GENESIS A CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN AWUNDAGA (PRESIDENT)
(646) 730-0249
Entity
Organization
Contact information
Practice address
442 BROADWAY, CAMDEN, NJ 08103-1246
(646) 730-0249
Mailing address
442 BROADWAY, CAMDEN, NJ 08103-1246
(646) 730-0249
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QC1800X
Corporate Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
—
Other
Enumeration date
10/14/2025
Last updated
05/13/2026
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