| Jennifer Pothen, MD | |
|
1 Dakota Dr Ste 218, New Hyde Park, NY 11042-1136 | |
| (516) 488-9700 | |
| (516) 488-8826 |
| Full Name | Jennifer Pothen |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 1 Dakota Dr Ste 218, New Hyde Park, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255772307 | NPI | - | NPPES |
| 008046940 | Medicaid | CT | |
| 07530096 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 52266 (Connecticut) | Secondary |
| 207Q00000X | Family Medicine | 315296 (New York) | Primary |
| Entity Name | Hartford Healthcare Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043561301 PECOS PAC ID: 1153573902 Enrollment ID: O20121201000007 |
| Entity Name | Optum Medical Care Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982643003 PECOS PAC ID: 9931013240 Enrollment ID: O20190326000454 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Pothen, MD 47 Town St, Norwich, CT 06360-2315 Ph: (860) 892-7042 | Jennifer Pothen, MD 1 Dakota Dr Ste 218, New Hyde Park, NY 11042-1136 Ph: (516) 488-9700 |
Yelena Pyatov, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 27005 76th Ave, Department Of Pediatrics, New Hyde Park, NY 11040 Phone: 718-470-7700 | |
Amber Haq, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Dakota Dr, New Hyde Park, NY 11042 Phone: 516-622-6000 | |
Boahen Owusu Kwakye, AGNP Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3000 Marcus Ave Ste 2w15, New Hyde Park, NY 11042 Phone: 855-201-4988 | |
Martha Arden, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2001 Marcus Ave, Suite N204, New Hyde Park, NY 11042 Phone: 347-882-1321 | |
Mrs. Adelina Fazilov, FNP Family Medicine Medicare: Medicare Enrolled Practice Location: 450 Lakeville Rd, New Hyde Park, NY 11042 Phone: 516-487-9454 Fax: 516-487-2745 | |
Dr. Anam Sarfaraz, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1991 Marcus Ave Fl 2, New Hyde Park, NY 11042 Phone: 516-354-1600 Fax: 516-941-4677 | |
Dr. Justin Chen, DO Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1 Dakota Dr, New Hyde Park, NY 11042 Phone: 516-622-6020 Fax: 516-622-6021 |