| Cmc Of Pa Pc | |
|
1021 Old York Rd Ste 301 Abington PA 19001-4626 | |
| (215) 254-6000 | |
| Not Available |
| Full Name | Cmc Of Pa Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1021 Old York Rd Ste 301, Abington, Pennsylvania |
| Authorized Official Name and Position | Mandie Matthews (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 6107639413 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cmc Of Pa Pc 1021 Old York Rd Ste 301 Abington PA 19001-4626 Ph: (215) 395-8266 | Cmc Of Pa Pc 1021 Old York Rd Ste 301 Abington PA 19001-4626 Ph: (215) 254-6000 |
| NPI Number | 1083341341 |
|---|---|
| Provider Enumeration Date | 08/05/2022 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Medicare PECOS PAC ID | 7113393497 |
|---|---|
| Medicare Enrollment ID | O20221012002274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083341341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Donna L Lauck |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1174665442 PECOS PAC ID: 0244136141 Enrollment ID: I20031211000037 |
| Provider Name | Guillermo Roberto Otero-perez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962441725 PECOS PAC ID: 7911903976 Enrollment ID: I20061013000472 |
| Provider Name | Roberto Jorge Ortiz-aguayo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205031275 PECOS PAC ID: 7315030897 Enrollment ID: I20070830000033 |
| Provider Name | M Samson Seplow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477686608 PECOS PAC ID: 0446323125 Enrollment ID: I20080715000284 |
| Provider Name | Robert F Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609001668 PECOS PAC ID: 1355492265 Enrollment ID: I20090706000082 |
| Provider Name | Sudha Jairaj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902980857 PECOS PAC ID: 8123210176 Enrollment ID: I20101008000187 |
| Provider Name | Richard L Yudell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003990797 PECOS PAC ID: 0042402836 Enrollment ID: I20101012000842 |
| Provider Name | Frances Aledo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912110859 PECOS PAC ID: 1557400058 Enrollment ID: I20130109000141 |
| Provider Name | Armand G Diyenno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811318447 PECOS PAC ID: 2567680812 Enrollment ID: I20140827002533 |
| Provider Name | Donald Eugene Cramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881001550 PECOS PAC ID: 2466671490 Enrollment ID: I20140924000055 |
| Provider Name | Agata H Kaminska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366544967 PECOS PAC ID: 5597782474 Enrollment ID: I20160215001859 |
| Provider Name | Denise Rageis |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1427599430 PECOS PAC ID: 7012285877 Enrollment ID: I20170620000673 |
| Provider Name | Lyn Rairdon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922517317 PECOS PAC ID: 9436416138 Enrollment ID: I20171206000159 |
| Provider Name | Kevin Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023096054 PECOS PAC ID: 4688804289 Enrollment ID: I20190325001017 |
| Provider Name | Alexandria L Dougherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962773499 PECOS PAC ID: 3779917802 Enrollment ID: I20191226001557 |
| Provider Name | Eve Bosnick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417938531 PECOS PAC ID: 4880013812 Enrollment ID: I20200924002226 |
| Provider Name | Ann Marie Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518570126 PECOS PAC ID: 6305025115 Enrollment ID: I20201015001044 |
| Provider Name | Nadine Georgia Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194367177 PECOS PAC ID: 2163836123 Enrollment ID: I20210202003119 |
| Provider Name | Dorsa H Seimaa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235712530 PECOS PAC ID: 4789079104 Enrollment ID: I20220322002683 |
| Provider Name | Hannah Baumstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639837867 PECOS PAC ID: 0143615401 Enrollment ID: I20220323001517 |
| Provider Name | Kelsey Topham |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033754973 PECOS PAC ID: 5597122630 Enrollment ID: I20230606001562 |
| Provider Name | Jewel Daye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841986023 PECOS PAC ID: 8325406622 Enrollment ID: I20230619001534 |
| Provider Name | Christina Villani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962195537 PECOS PAC ID: 5092173302 Enrollment ID: I20230619001883 |
| Provider Name | Colin Tracey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295427706 PECOS PAC ID: 9537527841 Enrollment ID: I20230619001893 |
| Provider Name | Nakia N Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477257202 PECOS PAC ID: 5193183390 Enrollment ID: I20230621000265 |
| Provider Name | Jennifer Danielle Schell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558058453 PECOS PAC ID: 3779941976 Enrollment ID: I20230621000441 |
| Provider Name | Dawn Debrocco |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750724027 PECOS PAC ID: 8527428903 Enrollment ID: I20230717002625 |
| Provider Name | Steven G Simms |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881970556 PECOS PAC ID: 8022471929 Enrollment ID: I20230824003754 |
| Provider Name | Nicolette Macri |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588349179 PECOS PAC ID: 3274980677 Enrollment ID: I20231107000915 |
| Provider Name | Marissa B Hendrixson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023881273 PECOS PAC ID: 9739538737 Enrollment ID: I20231216000044 |
| Provider Name | Linda Theresa Xuen Yen Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548041619 PECOS PAC ID: 8426407321 Enrollment ID: I20231216000276 |
| Provider Name | Gabrielle Dalton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063292415 PECOS PAC ID: 0547619439 Enrollment ID: I20231218003797 |
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