| Dr Shelley Gittens, MD | |
|
1865 Tamarack Rd, Newark, OH 43055 | |
| (220) 564-4935 | |
| (220) 564-4944 |
| Full Name | Dr Shelley Gittens |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1865 Tamarack Rd, Newark, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801895990 | NPI | - | NPPES |
| 2145664 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0204X | Pediatrics - Pediatric Emergency Medicine | 35077113 (Ohio) | Secondary |
| 208000000X | Pediatrics | 35-077113 (Ohio) | Primary |
| Entity Name | Pediatric Academic Association, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063419943 PECOS PAC ID: 2961306774 Enrollment ID: O20031124000198 |
| Entity Name | Licking Memorial Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326072265 PECOS PAC ID: 6204740731 Enrollment ID: O20031203000131 |
| Entity Name | Nationwide Children's Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851179873 PECOS PAC ID: 0042385064 Enrollment ID: O20240214002279 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shelley Gittens, MD 1865 Tamarack Rd, Newark, OH 43055-2305 Ph: (220) 564-4935 | Dr Shelley Gittens, MD 1865 Tamarack Rd, Newark, OH 43055 Ph: (220) 564-4935 |
Dr. Hanaa Abdelmessih, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1865 Tamarack Rd, Newark, OH 43055 Phone: 220-564-4934 Fax: 220-564-4944 | |
Jimisha Patel, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1864 Tamarack Road, Newark, OH 43055 Phone: 220-564-4939 Fax: 220-564-4944 | |
Priyanshi Patel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 399 E Main St, Newark, OH 43055 Phone: 220-564-1840 Fax: 220-564-1841 | |
Dr. Richard Baltisberger, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1865 Tamarack Rd, Newark, OH 43055 Phone: 220-564-4940 Fax: 220-564-4930 | |
Allison Bosse, CPNP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1671 W Main St, Newark, OH 43055 Phone: 740-522-5437 Fax: 740-522-9609 | |
Donna Jean Mcdonald, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1960 Tamarack Rd, Newark, OH 43055 Phone: 740-344-8687 Fax: 740-522-5110 | |
John Peter Lazar, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1320 West Main Street, Newark, OH 43055 Phone: 220-564-4000 Fax: 220-564-4342 |