| Shakespeare Operating Llc | |
|
1250 Shakespeare Ave, Bronx, NY 10452-3012 | |
| (718) 583-7736 | |
| (646) 350-1634 |
| Full Name | Shakespeare Operating Llc |
|---|---|
| Type | Facility |
| Speciality | Clinic/center - Multi-specialty |
| Location | 1250 Shakespeare Ave, Bronx, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720634538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Elena Pollack |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1366711350 PECOS PAC ID: 1658363478 Enrollment ID: I20040401000532 |
| Provider Name | Dennis S Nachmann |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174516355 PECOS PAC ID: 0749272151 Enrollment ID: I20040402000881 |
| Provider Name | Ali Sherzoy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245265297 PECOS PAC ID: 0840283602 Enrollment ID: I20040407000044 |
| Provider Name | Aruna Barua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609940121 PECOS PAC ID: 8628062262 Enrollment ID: I20040414001215 |
| Provider Name | Hilda A Haynes Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306927736 PECOS PAC ID: 3870574312 Enrollment ID: I20040528001023 |
| Provider Name | David Jakubowicz |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538169230 PECOS PAC ID: 6709856453 Enrollment ID: I20040729000505 |
| Provider Name | Praveen Kumrah |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568463842 PECOS PAC ID: 4587634233 Enrollment ID: I20040729000535 |
| Provider Name | Rakesh Gupta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255329876 PECOS PAC ID: 0446223374 Enrollment ID: I20040818000264 |
| Provider Name | Sandeep K Malik |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1154484525 PECOS PAC ID: 0547229114 Enrollment ID: I20041008000277 |
| Provider Name | Mariela Glandt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235301920 PECOS PAC ID: 2062477102 Enrollment ID: I20041130000829 |
| Provider Name | Charles E Libby |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1306954946 PECOS PAC ID: 5597719740 Enrollment ID: I20050310000137 |
| Provider Name | Timothy J Vittorio |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427044536 PECOS PAC ID: 6709813025 Enrollment ID: I20050719000553 |
| Provider Name | Ralph Jeudy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114925732 PECOS PAC ID: 0244265452 Enrollment ID: I20050927000759 |
| Provider Name | Srinivas Kesanakurthy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770558397 PECOS PAC ID: 5890714356 Enrollment ID: I20051115000223 |
| Provider Name | Hilary B Kern |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1033282934 PECOS PAC ID: 3072523752 Enrollment ID: I20060425000641 |
| Provider Name | Ravindra Kashyap |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639128366 PECOS PAC ID: 4688686264 Enrollment ID: I20060623000060 |
| Provider Name | Robert Seth Mahler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376580605 PECOS PAC ID: 7416952908 Enrollment ID: I20060915000067 |
| Provider Name | Edward Fruitman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558434134 PECOS PAC ID: 1254436488 Enrollment ID: I20070418000016 |
| Provider Name | Cynthia Prabahar Sudar Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114064425 PECOS PAC ID: 9638275415 Enrollment ID: I20070511000250 |
| Provider Name | Sarah A Stackpole |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1124183629 PECOS PAC ID: 5597865360 Enrollment ID: I20070709000355 |
| Provider Name | Sheryll Garcia |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932384906 PECOS PAC ID: 5092897389 Enrollment ID: I20080125000016 |
| Provider Name | Mazda Alaie |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174611164 PECOS PAC ID: 7618042730 Enrollment ID: I20080823000049 |
| Provider Name | Alfonso A Ortiz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1699915967 PECOS PAC ID: 5193882066 Enrollment ID: I20090319000516 |
| Provider Name | Kyle A Wiktor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326030495 PECOS PAC ID: 3476602129 Enrollment ID: I20090528000568 |
| Provider Name | Juadan Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902940331 PECOS PAC ID: 1052464203 Enrollment ID: I20090805000411 |
| Provider Name | Nirav S Patel |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1992951925 PECOS PAC ID: 3678612231 Enrollment ID: I20091120000454 |
| Provider Name | Muhammad A Ahmad |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1811125339 PECOS PAC ID: 4688716582 Enrollment ID: I20100114000663 |
| Provider Name | Marsha Marecki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801955745 PECOS PAC ID: 0749319234 Enrollment ID: I20100521000002 |
| Provider Name | Mohamad Erfani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093036469 PECOS PAC ID: 7113041161 Enrollment ID: I20100828000001 |
| Provider Name | Florence Pua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124105036 PECOS PAC ID: 3971796483 Enrollment ID: I20101015001206 |
| Provider Name | Casey A Pidich |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1619293826 PECOS PAC ID: 2961691613 Enrollment ID: I20110111000446 |
| Provider Name | Janet Ohare |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740590603 PECOS PAC ID: 4981889755 Enrollment ID: I20110421000553 |
| Provider Name | Haleh Nassiri |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013293166 PECOS PAC ID: 9133389000 Enrollment ID: I20120330000117 |
| Provider Name | Ananth Adurthy Shankar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811153695 PECOS PAC ID: 8022242932 Enrollment ID: I20131009000081 |
| Provider Name | Venkata Durbhaka |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1134563885 PECOS PAC ID: 6800035486 Enrollment ID: I20131022000648 |
| Provider Name | Tawfik A Zein |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265775308 PECOS PAC ID: 8325273147 Enrollment ID: I20131104000989 |
| Provider Name | Farbod Raiszadeh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336404128 PECOS PAC ID: 6608005475 Enrollment ID: I20140128000816 |
| Provider Name | Orin H Pearce |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891821609 PECOS PAC ID: 5698990380 Enrollment ID: I20140715000019 |
| Provider Name | Mital Pratik Saparia |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336552413 PECOS PAC ID: 6901027317 Enrollment ID: I20141029001031 |
| Provider Name | Rajwinder Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245635887 PECOS PAC ID: 8325361751 Enrollment ID: I20141216001196 |
| Provider Name | Kenneth Edward Bloom |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1477536068 PECOS PAC ID: 2163429457 Enrollment ID: I20150609001213 |
| Provider Name | Vinaya V Gaduputi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588829188 PECOS PAC ID: 0547576282 Enrollment ID: I20150826001521 |
| Provider Name | Anthonia Ajimavo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114309283 PECOS PAC ID: 0143536045 Enrollment ID: I20150908001225 |
| Provider Name | Jijy Easow |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508859539 PECOS PAC ID: 3072816362 Enrollment ID: I20160120001430 |
| Provider Name | Heesoo Karina Kim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144452749 PECOS PAC ID: 2860707866 Enrollment ID: I20160204000704 |
| Provider Name | Jennifer A. Aquino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285077636 PECOS PAC ID: 7113155128 Enrollment ID: I20160307000098 |
| Provider Name | Jonathan G Guterman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720285349 PECOS PAC ID: 6608091061 Enrollment ID: I20160622001405 |
| Provider Name | Amanda M Diamond |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1528422953 PECOS PAC ID: 6608168935 Enrollment ID: I20160707001171 |
| Provider Name | Frances Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831647817 PECOS PAC ID: 5597043117 Enrollment ID: I20161101001947 |
| Provider Name | Maya B Puri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992028542 PECOS PAC ID: 6800058751 Enrollment ID: I20170208002708 |
| Provider Name | Eliana Lopez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1740578269 PECOS PAC ID: 9830474717 Enrollment ID: I20170315001342 |
| Provider Name | Eric L. Altschuler |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1558384867 PECOS PAC ID: 7810924156 Enrollment ID: I20170420000170 |
| Provider Name | Andrew J Lerrick |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1730185513 PECOS PAC ID: 7911914643 Enrollment ID: I20170509002191 |
| Provider Name | Ruben N Rosario |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063783843 PECOS PAC ID: 4183991854 Enrollment ID: I20170531000522 |
| Provider Name | Nora L Benavides |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740558444 PECOS PAC ID: 2062771231 Enrollment ID: I20180116000222 |
| Provider Name | Alaa A Kalloub |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497196554 PECOS PAC ID: 8729340930 Enrollment ID: I20180328002782 |
| Provider Name | Ravinder Sharma |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497100895 PECOS PAC ID: 1658636709 Enrollment ID: I20180521001869 |
| Provider Name | Guillermo Gallardo |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134342439 PECOS PAC ID: 2365768942 Enrollment ID: I20180925002299 |
| Provider Name | Eldad Vered |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396815023 PECOS PAC ID: 9133143472 Enrollment ID: I20190306000907 |
| Provider Name | Shivang Desai |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1811288830 PECOS PAC ID: 3577860360 Enrollment ID: I20190619002302 |
| Provider Name | Nisha C Manglani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477024172 PECOS PAC ID: 3971837543 Enrollment ID: I20190702001108 |
| Provider Name | Miae Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912488974 PECOS PAC ID: 7810223831 Enrollment ID: I20190730001123 |
| Provider Name | Monica Cespedes Santana |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1114204161 PECOS PAC ID: 7214212653 Enrollment ID: I20190926000825 |
| Provider Name | Pendor Haiyede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215586490 PECOS PAC ID: 4880020510 Enrollment ID: I20200128003090 |
| Provider Name | Itisha Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740638196 PECOS PAC ID: 0749617314 Enrollment ID: I20200219002880 |
| Provider Name | Virginia Wei-cheng Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740706472 PECOS PAC ID: 3173946191 Enrollment ID: I20200709002637 |
| Provider Name | Pooja Shah |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821520933 PECOS PAC ID: 1951725910 Enrollment ID: I20200723000524 |
| Provider Name | Jyoti S Drall |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245327907 PECOS PAC ID: 1052735701 Enrollment ID: I20200728001576 |
| Provider Name | Marie M. Medina-merveille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407383193 PECOS PAC ID: 8022434372 Enrollment ID: I20200817003090 |
| Provider Name | Zyeshia L Jenkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134678279 PECOS PAC ID: 2567889223 Enrollment ID: I20200827000258 |
| Provider Name | Binu Kuriakose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649705328 PECOS PAC ID: 4688919780 Enrollment ID: I20200915001371 |
| Provider Name | Linda Kwartemaa Boamah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447885157 PECOS PAC ID: 0143648493 Enrollment ID: I20200917002815 |
| Provider Name | Khadine Harrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164043311 PECOS PAC ID: 2466863576 Enrollment ID: I20201120002240 |
| Provider Name | Lisa A Horowitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245584549 PECOS PAC ID: 4385056753 Enrollment ID: I20201209002796 |
| Provider Name | Sharleen Carema Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134729809 PECOS PAC ID: 7113339987 Enrollment ID: I20201220000005 |
| Provider Name | Onelys Rodriguez Rosario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578165999 PECOS PAC ID: 3375956857 Enrollment ID: I20201229002687 |
| Provider Name | John Fadel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700272499 PECOS PAC ID: 5496189227 Enrollment ID: I20210122000130 |
| Provider Name | Jane Sim |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1952833584 PECOS PAC ID: 4981941226 Enrollment ID: I20210122001764 |
| Provider Name | Angela Marizol Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528682770 PECOS PAC ID: 0244644474 Enrollment ID: I20210130000016 |
| Provider Name | Gaele Pompee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851997191 PECOS PAC ID: 7012322837 Enrollment ID: I20210209000052 |
| Provider Name | Nelaja L'elie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821494451 PECOS PAC ID: 3476968108 Enrollment ID: I20210210002355 |
| Provider Name | Anne Wold |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427031061 PECOS PAC ID: 6800862970 Enrollment ID: I20210219001807 |
| Provider Name | Keshav Teelucksingh |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1003164179 PECOS PAC ID: 0042582355 Enrollment ID: I20210511002873 |
| Provider Name | Ralph Balintong Mosher |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770154981 PECOS PAC ID: 0941603021 Enrollment ID: I20210727002471 |
| Provider Name | Catalina Trevino Saenz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275991747 PECOS PAC ID: 5193129575 Enrollment ID: I20210806001212 |
| Provider Name | Adam S Splaver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932155983 PECOS PAC ID: 0244217347 Enrollment ID: I20210827001766 |
| Provider Name | Chowdhury Nusrat Farooqui Tania |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083103030 PECOS PAC ID: 2062818644 Enrollment ID: I20210907002455 |
| Provider Name | Foram Vishal Udeshi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1639660038 PECOS PAC ID: 8426455890 Enrollment ID: I20210928001284 |
| Provider Name | Bladimir Quijano-rondan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1528417565 PECOS PAC ID: 8921346891 Enrollment ID: I20211110000618 |
| Provider Name | Ashish Goel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790262939 PECOS PAC ID: 2567851231 Enrollment ID: I20211118000903 |
| Provider Name | Gene Rosenberg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1093716219 PECOS PAC ID: 2769468719 Enrollment ID: I20220106001233 |
| Provider Name | Erewarifagha M Haidome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114301728 PECOS PAC ID: 7911399845 Enrollment ID: I20220126001024 |
| Provider Name | Monika Raj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376156034 PECOS PAC ID: 2062807191 Enrollment ID: I20220328000636 |
| Provider Name | Sai Krishna Koyoda |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1902327356 PECOS PAC ID: 6204214695 Enrollment ID: I20220525001244 |
| Provider Name | Priyal Vinod Bhagat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790280105 PECOS PAC ID: 3678951316 Enrollment ID: I20220608001168 |
| Provider Name | Aakash Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790206415 PECOS PAC ID: 5395015762 Enrollment ID: I20220608001915 |
| Provider Name | Mohammed Abdulrahman Yousuf |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144727421 PECOS PAC ID: 6204215627 Enrollment ID: I20220615001199 |
| Provider Name | David Murray Corwin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770538381 PECOS PAC ID: 1759766645 Enrollment ID: I20220913002262 |
| Provider Name | Kohely Paulino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316503675 PECOS PAC ID: 9638547409 Enrollment ID: I20221129001299 |
| Provider Name | Oluchi Eke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699403287 PECOS PAC ID: 8123499647 Enrollment ID: I20230120000568 |
| Provider Name | John Missanelli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124134341 PECOS PAC ID: 5092743328 Enrollment ID: I20230201003126 |
| Provider Name | Landy F Pollas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710602701 PECOS PAC ID: 8022487602 Enrollment ID: I20230207001001 |
| Provider Name | Carley Ann Keim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932660099 PECOS PAC ID: 7618349127 Enrollment ID: I20230209002575 |
| Provider Name | Sunil Singh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841229382 PECOS PAC ID: 4486552106 Enrollment ID: I20230217002139 |
| Provider Name | Catherine Donkoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003529298 PECOS PAC ID: 7416312475 Enrollment ID: I20230426000391 |
| Provider Name | Summer Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922719814 PECOS PAC ID: 3779942370 Enrollment ID: I20230629002192 |
| Provider Name | Emma Otieno |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1730716119 PECOS PAC ID: 3072972595 Enrollment ID: I20230630002455 |
| Provider Name | Andrew Hannah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073298568 PECOS PAC ID: 1254792039 Enrollment ID: I20230726000784 |
| Provider Name | Sakshi Vishwas Chavan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487334348 PECOS PAC ID: 4284096991 Enrollment ID: I20230811002875 |
| Provider Name | Adam Saeed Fakir |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1821640343 PECOS PAC ID: 9234591546 Enrollment ID: I20230818001098 |
| Provider Name | Mimerose Lang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437880648 PECOS PAC ID: 8527421692 Enrollment ID: I20230823001942 |
| Provider Name | Janice Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497455265 PECOS PAC ID: 2567817646 Enrollment ID: I20231010000903 |
| Provider Name | Pratibha Surathi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619455318 PECOS PAC ID: 1850746827 Enrollment ID: I20231011001055 |
| Provider Name | Chinyere Nora Ogbonna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982306775 PECOS PAC ID: 9234584244 Enrollment ID: I20231011002951 |
| Provider Name | Tkeyah Ebony Whaley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154839405 PECOS PAC ID: 6709233455 Enrollment ID: I20231117000342 |
| Provider Name | Kousilla Cheung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649055922 PECOS PAC ID: 5294183638 Enrollment ID: I20231127001100 |
| Provider Name | Idit Rosenblum |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376828293 PECOS PAC ID: 0648628438 Enrollment ID: I20231205001923 |
| Provider Name | Alecia Dt Bailey-wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437854825 PECOS PAC ID: 8022468669 Enrollment ID: I20231222001989 |
| Provider Name | Barbara Witek Matricardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295515989 PECOS PAC ID: 6507217882 Enrollment ID: I20240111000956 |
| Provider Name | Gary Jean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306544473 PECOS PAC ID: 2466813985 Enrollment ID: I20240131001990 |
| Provider Name | Minh Tam T Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235710484 PECOS PAC ID: 1951754316 Enrollment ID: I20240201001915 |
| Provider Name | Kimia Mirabbaszadeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013795772 PECOS PAC ID: 8426401803 Enrollment ID: I20240201002603 |
| Provider Name | Marissa A. Reuter |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1437927670 PECOS PAC ID: 7113360249 Enrollment ID: I20240206002317 |
| Provider Name | Dhwani Parikh |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164285011 PECOS PAC ID: 5294179107 Enrollment ID: I20240220000581 |
| Provider Name | Shweta Arvindbhai Dholariya |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013786474 PECOS PAC ID: 1153766506 Enrollment ID: I20240226002493 |
| Provider Name | Temilola Yewande Esan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851941199 PECOS PAC ID: 7315383726 Enrollment ID: I20240307003229 |
| Provider Name | Charles Edwards |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427490473 PECOS PAC ID: 3870939564 Enrollment ID: I20240317000069 |
| Provider Name | William Montes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528674355 PECOS PAC ID: 7012354541 Enrollment ID: I20240320001340 |
| Provider Name | Jahnique Sackiya Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114797933 PECOS PAC ID: 9032556261 Enrollment ID: I20240325000865 |
| Provider Name | Christena O Barton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033684188 PECOS PAC ID: 2264879238 Enrollment ID: I20240326002704 |
| Provider Name | Marie G Duclair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649051921 PECOS PAC ID: 6204273139 Enrollment ID: I20240327000930 |
| Provider Name | Renee Marrian Lewis-duquesnay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295506228 PECOS PAC ID: 4183062243 Enrollment ID: I20240409001596 |
| Provider Name | Esther Jung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336788298 PECOS PAC ID: 1153760608 Enrollment ID: I20240416003251 |
| Provider Name | Natisha Stefanie Wint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407632169 PECOS PAC ID: 9638519119 Enrollment ID: I20240501000948 |
| Provider Name | Lela Anne Karlawish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982479663 PECOS PAC ID: 4082054515 Enrollment ID: I20240501003193 |
| Provider Name | Johnna Rose Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538931209 PECOS PAC ID: 3779923172 Enrollment ID: I20240502001494 |
| Provider Name | Adam Jimoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821352634 PECOS PAC ID: 3577903897 Enrollment ID: I20240502002841 |
| Provider Name | Momina Arif |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457114233 PECOS PAC ID: 6709227853 Enrollment ID: I20240507004207 |
| Provider Name | Bassira Famah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932833738 PECOS PAC ID: 9436590148 Enrollment ID: I20240513002361 |
| Provider Name | Mohita Dutta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013782903 PECOS PAC ID: 2668813148 Enrollment ID: I20240515001309 |
| Provider Name | Simranjit Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407467822 PECOS PAC ID: 8729420807 Enrollment ID: I20240521001441 |
| Provider Name | Omolola Kofoworola Oloyede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316333479 PECOS PAC ID: 3577930429 Enrollment ID: I20240603001313 |
| Provider Name | Constance Okafor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518728856 PECOS PAC ID: 7810439692 Enrollment ID: I20240607001976 |
| Provider Name | Jennifer Cushman |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1609334325 PECOS PAC ID: 2769834860 Enrollment ID: I20240610000520 |
| Provider Name | Mandip Chahil |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356014260 PECOS PAC ID: 7810359932 Enrollment ID: I20240613001305 |
| Provider Name | Sherry Grimes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992953293 PECOS PAC ID: 6901349372 Enrollment ID: I20240614000113 |
| Provider Name | Scott Dinesen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508858614 PECOS PAC ID: 4789578402 Enrollment ID: I20240710004735 |
| Provider Name | Tariq Rasheed |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1932776341 PECOS PAC ID: 4587109236 Enrollment ID: I20240717002902 |
| Provider Name | Ashley Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851545016 PECOS PAC ID: 0446796304 Enrollment ID: I20240726003266 |
| Provider Name | Eileen Rosario |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922576412 PECOS PAC ID: 9537537667 Enrollment ID: I20240729001880 |
| Provider Name | Guylene Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962944884 PECOS PAC ID: 5294010856 Enrollment ID: I20240801001367 |
| Provider Name | Kyoung-yi Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376313312 PECOS PAC ID: 5395283105 Enrollment ID: I20240812002331 |
| Provider Name | Millicent F Moseray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285416958 PECOS PAC ID: 8022556760 Enrollment ID: I20240813003275 |
| Provider Name | Emily Floode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982143343 PECOS PAC ID: 5890067920 Enrollment ID: I20240813003666 |
| Provider Name | Adam Benjamin Katz Cadesky |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1528616984 PECOS PAC ID: 0042758567 Enrollment ID: I20240815001524 |
| Provider Name | Phinehas Jacques |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780452672 PECOS PAC ID: 1456899814 Enrollment ID: I20240815003553 |
| Provider Name | Nikita Renee Dow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043971245 PECOS PAC ID: 3779021167 Enrollment ID: I20240816000572 |
| Provider Name | Nsemboowo Enyong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477328839 PECOS PAC ID: 1254505712 Enrollment ID: I20240816001102 |
| Provider Name | Tashanna Gillard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073371522 PECOS PAC ID: 4688114564 Enrollment ID: I20240905004030 |
| Provider Name | Anjali Yagnik |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013741404 PECOS PAC ID: 9133669757 Enrollment ID: I20240910003693 |
| Provider Name | Kyungje Sung |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1851950703 PECOS PAC ID: 0840616314 Enrollment ID: I20241001001622 |
| Provider Name | Gabriella R Lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235616889 PECOS PAC ID: 4082145743 Enrollment ID: I20241004001850 |
| Provider Name | Justin Ray Cowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528803988 PECOS PAC ID: 8224569983 Enrollment ID: I20241004002048 |
| Provider Name | Stella Nkem Okechukwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922299965 PECOS PAC ID: 8123559812 Enrollment ID: I20241004003037 |
| Provider Name | Dennis Robert Berhalter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184206443 PECOS PAC ID: 0941733679 Enrollment ID: I20241101001776 |
| Provider Name | Matthew Tse |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1063080851 PECOS PAC ID: 8729512215 Enrollment ID: I20241106001327 |
| Provider Name | Ada Lyn Yao |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1891100590 PECOS PAC ID: 1052625431 Enrollment ID: I20241106003395 |
| Provider Name | Roberto Arana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992543045 PECOS PAC ID: 6103350970 Enrollment ID: I20241115002068 |
| Provider Name | Heta Mehta |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649093733 PECOS PAC ID: 7618401357 Enrollment ID: I20241118000631 |
| Provider Name | John Califano |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1720124381 PECOS PAC ID: 0446419238 Enrollment ID: I20241119001748 |
| Provider Name | Melissa Yohanna Contreras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467290759 PECOS PAC ID: 0042745259 Enrollment ID: I20241125003661 |
| Provider Name | Abdul Hussain Vali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942863410 PECOS PAC ID: 4284962465 Enrollment ID: I20241127000601 |
| Provider Name | Patricia A Murphy |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1750381091 PECOS PAC ID: 8123015013 Enrollment ID: I20241205001028 |
| Provider Name | Jhanna M Francisco Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538989322 PECOS PAC ID: 4981130630 Enrollment ID: I20241205001361 |
| Provider Name | Guylante Jules |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740881200 PECOS PAC ID: 6800322371 Enrollment ID: I20241206001618 |
| Provider Name | Matri Nayanbhai Chhaya |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871328872 PECOS PAC ID: 7315474020 Enrollment ID: I20241219001110 |
| Provider Name | Saheed Shittu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952644593 PECOS PAC ID: 7012456973 Enrollment ID: I20241220003059 |
| Provider Name | Gabriela Taveras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104632538 PECOS PAC ID: 9133656309 Enrollment ID: I20241230002024 |
| Provider Name | Melissa Christine Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407686538 PECOS PAC ID: 5597293365 Enrollment ID: I20250107001676 |
| Provider Name | Joy Shakelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003334822 PECOS PAC ID: 8729354212 Enrollment ID: I20250107003046 |
| Provider Name | Shyavia Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205267853 PECOS PAC ID: 6305374166 Enrollment ID: I20250108001517 |
| Provider Name | Clement Asemota |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437520848 PECOS PAC ID: 4587192232 Enrollment ID: I20250109001493 |
| Provider Name | Sonia Innocent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780404681 PECOS PAC ID: 8426586058 Enrollment ID: I20250110000945 |
| Provider Name | Nand Shah |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861178725 PECOS PAC ID: 5890223952 Enrollment ID: I20250116003537 |
| Provider Name | Nityananda Rao Jakkula |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225700933 PECOS PAC ID: 8123557170 Enrollment ID: I20250121002729 |
| Provider Name | Stephanie Coral Mangual |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801585385 PECOS PAC ID: 5597112193 Enrollment ID: I20250123001533 |
| Provider Name | Caitlin Cherry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134935539 PECOS PAC ID: 9931638772 Enrollment ID: I20250123003539 |
| Provider Name | Shanikqua Renee Palmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013480185 PECOS PAC ID: 3274053285 Enrollment ID: I20250220003056 |
| Provider Name | Diana Roata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437964202 PECOS PAC ID: 7214457696 Enrollment ID: I20250228001818 |
| Provider Name | Fan Wu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710783493 PECOS PAC ID: 5395266571 Enrollment ID: I20250304002299 |
| Provider Name | Marjorie Felix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851083588 PECOS PAC ID: 3870941131 Enrollment ID: I20250306001295 |
| Provider Name | Tali Kluk Kusnir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083421663 PECOS PAC ID: 0345761334 Enrollment ID: I20250306001741 |
| Provider Name | Jamie Scott Seigal |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1720009392 PECOS PAC ID: 8921238791 Enrollment ID: I20250321001739 |
| Provider Name | Saundra Tawana Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982406302 PECOS PAC ID: 4880117647 Enrollment ID: I20250402001489 |
| Provider Name | Michael J Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972948073 PECOS PAC ID: 4284158775 Enrollment ID: I20250407000268 |
| Provider Name | Kaylin Marie Lemelle-thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235945239 PECOS PAC ID: 8628592516 Enrollment ID: I20250414000218 |
| Provider Name | Kimberly Quinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831918747 PECOS PAC ID: 4880110675 Enrollment ID: I20250424001587 |
| Provider Name | Angela Theresa Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326708272 PECOS PAC ID: 3779009451 Enrollment ID: I20250424003783 |
| Provider Name | Linda Amarachukwu Lekweuwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255644241 PECOS PAC ID: 2466979828 Enrollment ID: I20250508001854 |
| Provider Name | Sharee N Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619757119 PECOS PAC ID: 3274051156 Enrollment ID: I20250514002535 |
| Provider Name | Javelle Marie Mcelhaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619141249 PECOS PAC ID: 0648780098 Enrollment ID: I20250605003608 |
| Provider Name | Angela Tewa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578134615 PECOS PAC ID: 7416467873 Enrollment ID: I20250605003794 |
| Provider Name | Jon Bieschke |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1659105146 PECOS PAC ID: 8224549647 Enrollment ID: I20250613000624 |
| Mailing Address | Practice Location Address |
|---|---|
| Shakespeare Operating Llc 2626 Halperin Ave, Bronx, NY 10461-2631 Ph: (718) 618-0401 | Shakespeare Operating Llc 1250 Shakespeare Ave, Bronx, NY 10452-3012 Ph: (718) 583-7736 |