| Aldad Medical Pc | |
|
400 Renaissance Ctr Ste 2600 Detroit MI 48243-1502 | |
| (516) 505-7200 | |
| Not Available |
| Full Name | Aldad Medical Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 400 Renaissance Ctr Ste 2600, Detroit, Michigan |
| Authorized Official Name and Position | Tamir Aldad (CEO) |
| Authorized Official Contact | 5165057200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aldad Medical Pc 510 Hempstead Tpke Rm 203 West Hempstead NY 11552-1152 Ph: (516) 505-7200 | Aldad Medical Pc 400 Renaissance Ctr Ste 2600 Detroit MI 48243-1502 Ph: (516) 505-7200 |
| NPI Number | 1154088771 |
|---|---|
| Provider Enumeration Date | 11/18/2021 |
| Last Update Date | 03/28/2023 |
| Certification Date | 03/28/2023 |
| Medicare PECOS PAC ID | 5395152201 |
|---|---|
| Medicare Enrollment ID | O20211203001611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154088771 | NPI | - | NPPES |
| 4301505906 | Other | MI | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jenna L Chambless |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1114209988 PECOS PAC ID: 7113190380 Enrollment ID: I20111103000293 |
| Provider Name | Tamir S Aldad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407207830 PECOS PAC ID: 3577817899 Enrollment ID: I20211203001670 |
| Provider Name | Jenna Taglienti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497915995 PECOS PAC ID: 7113180340 Enrollment ID: I20220711003435 |
| Provider Name | Annette Mills Mccoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225560915 PECOS PAC ID: 0749656106 Enrollment ID: I20221026002267 |
| Provider Name | David Strunk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265966535 PECOS PAC ID: 4183091408 Enrollment ID: I20221029000222 |
| Provider Name | Holly Richard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477182491 PECOS PAC ID: 3274903281 Enrollment ID: I20230110000146 |
| Provider Name | Stacey Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457059453 PECOS PAC ID: 5395102156 Enrollment ID: I20230609000498 |
| Provider Name | Erik Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841988029 PECOS PAC ID: 8921465675 Enrollment ID: I20230612001000 |
| Provider Name | Ariana Springgate |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891269981 PECOS PAC ID: 2567823271 Enrollment ID: I20230727002621 |
| Provider Name | Paul Folk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003502204 PECOS PAC ID: 8921461666 Enrollment ID: I20230829003079 |
| Provider Name | Karolyn Rose Coulouris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104522770 PECOS PAC ID: 2860855327 Enrollment ID: I20230830004034 |
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