| Alay Health Team | |
|
2351 Silvernail Rd Pewaukee WI 53072-5402 | |
| (262) 260-9000 | |
| (262) 260-9109 |
| Full Name | Alay Health Team |
|---|---|
| Speciality | Clinic/Center |
| Location | 2351 Silvernail Rd, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Carmen Kosicek (CEO, FOUNDER) |
| Authorized Official Contact | 2602609000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alay Health Team 2351 Silvernail Rd Pewaukee WI 53072-5402 Ph: (262) 260-9000 | Alay Health Team 2351 Silvernail Rd Pewaukee WI 53072-5402 Ph: (262) 260-9000 |
| NPI Number | 1114377702 |
|---|---|
| Provider Enumeration Date | 06/15/2016 |
| Last Update Date | 01/31/2023 |
| Certification Date | 01/31/2023 |
| Medicare PECOS PAC ID | 1557628039 |
|---|---|
| Medicare Enrollment ID | O20171208002007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114377702 | NPI | - | NPPES |
| Provider Name | Christina M Fuchs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487014296 PECOS PAC ID: 3173812302 Enrollment ID: I20160511001945 |
| Provider Name | Carmen Kosicek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255863767 PECOS PAC ID: 3375800857 Enrollment ID: I20171208002064 |
| Provider Name | Bobbi Jo Durst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407405566 PECOS PAC ID: 2961839253 Enrollment ID: I20200226001971 |
| Provider Name | Chelsea Schwartz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942818588 PECOS PAC ID: 9638584550 Enrollment ID: I20210226000079 |
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