| Genelle Cherise Vickianna Gittens-backus, MD | |
|
110 Liberty St, Brockton, MA 02301-5674 | |
| (508) 565-3055 | |
| Not Available |
| Full Name | Genelle Cherise Vickianna Gittens-backus |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 9 Years |
| Location | 110 Liberty St, Brockton, Massachusetts |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932553971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 1014882 (Massachusetts) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | 25MA12372500 (New Jersey) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cooper University Hospital | Camden, NJ | Hospital |
| Inspira Medical Center Vineland | Vineland, NJ | Hospital |
| Inspira Medical Center Elmer | Elmer, NJ | Hospital |
| Cape Regional Medical Center Inc | Cape may court house, NJ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cooper University Radiology Pc | 6305838764 | 58 |
| Entity Name | Cooper University Radiology Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336188291 PECOS PAC ID: 6305838764 Enrollment ID: O20040402001110 |
| Mailing Address | Practice Location Address |
|---|---|
| Genelle Cherise Vickianna Gittens-backus, MD 1 Federal St Ste 200, Camden, NJ 08103-1088 Ph: (848) 288-6935 | Genelle Cherise Vickianna Gittens-backus, MD 110 Liberty St, Brockton, MA 02301-5674 Ph: (508) 565-3055 |
Steven H Oh, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 235 N Pearl St, Brockton, MA 02301 Phone: 508-427-2665 Fax: 508-427-2538 | |
David E Osayande, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 680 Centre St, Brockton, MA 02302 Phone: 508-941-7000 | |
Stephen T Sweriduk, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 265 Westgate Dr, Brockton, MA 02301 Phone: 800-258-4674 Fax: 508-897-3198 | |
Ketan Patel, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 265 Westgate Dr, Brockton, Brockton, MA 02301 Phone: 800-258-4674 Fax: 508-897-3198 | |
George William Poulos, M.D., PH.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 680 Centre St, Signature Healthcare, Brockton Hospital, Radiology, Brockton, MA 02302 Phone: 508-941-7150 | |
Dr. Bruce Kenneth Bertrand, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 110 Liberty St, Brockton, MA 02301 Phone: 508-565-3275 | |
Jorge Ganson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 235 N Pearl St, Radiology Department, Brockton, MA 02301 Phone: 508-427-3106 Fax: 508-427-2538 |