| Nathan M Devenney, MD | |
|
22 Red Jacket St, Dansville, NY 14437 | |
| (585) 335-5200 | |
| (585) 335-8579 |
| Full Name | Nathan M Devenney |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Adolescent Medicine |
| Location | 22 Red Jacket St, Dansville, 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 |
|---|---|---|---|
| 1578023727 | NPI | - | NPPES |
| 07757459 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 324545 (New York) | Secondary |
| 208000000X | Pediatrics | 125.074934 (Illinois) | Secondary |
| 2080A0000X | Pediatrics - Adolescent Medicine | 324545 (New York) | Primary |
| Entity Name | Crystal Run Healthcare Physicians Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952376410 PECOS PAC ID: 6901792696 Enrollment ID: O20040227000791 |
| Mailing Address | Practice Location Address |
|---|---|
| Nathan M Devenney, MD Po Box 499, Dansville, NY 14437 Ph: (585) 335-5200 | Nathan M Devenney, MD 22 Red Jacket St, Dansville, NY 14437 Ph: (585) 335-5200 |
Caitlin Albano, Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 22 Red Jacket St, Dansville, NY 14437 Phone: 585-335-5200 | |
Deanna Lyons, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 22 Red Jacket St, Dansville, NY 14437 Phone: 585-335-5200 Fax: 585-335-5037 | |
Dr. David H Breen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 36 Elizabeth St, Dansville, NY 14437 Phone: 585-335-2030 Fax: 585-235-2035 | |
Dr. Jason Elwell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 22 Red Jacket St, Stony Brook Pediatrics, Dansville, NY 14437 Phone: 585-335-5200 Fax: 585-335-5037 | |
Ms. Kathryn Anesa Bennett, PNP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 22 Red Jacket Street, Dansville, NY 14437 Phone: 585-335-5200 Fax: 585-335-5037 | |
Penelope L Parris, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 22 Red Jacket Street, Dansville, NY 14437 Phone: 585-335-5200 Fax: 585-335-8579 |