| Freeway Psychiatry Pc | |
|
9225 John F Kennedy Blvd North Bergen NJ 07047 | |
| (201) 500-9755 | |
| Not Available |
| Full Name | Freeway Psychiatry Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 9225 John F Kennedy Blvd, North Bergen, New Jersey |
| Authorized Official Name and Position | Igor Vaine (ADMINISTRATOR) |
| Authorized Official Contact | 9737874174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Freeway Psychiatry Pc 9225 John F Kennedy Blvd North Bergen NJ 07047 Ph: (201) 500-9755 | Freeway Psychiatry Pc 9225 John F Kennedy Blvd North Bergen NJ 07047 Ph: (201) 500-9755 |
| NPI Number | 1831819531 |
|---|---|
| Provider Enumeration Date | 09/01/2022 |
| Last Update Date | 09/01/2022 |
| Certification Date | 08/30/2022 |
| Medicare PECOS PAC ID | 6901274844 |
|---|---|
| Medicare Enrollment ID | O20221123002571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831819531 | NPI | - | NPPES |
| Provider Name | Pamela Rose-deandrea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114177045 PECOS PAC ID: 7113080904 Enrollment ID: I20090105000435 |
| Provider Name | Luis A Febus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407026248 PECOS PAC ID: 2062576978 Enrollment ID: I20090121000406 |
| Provider Name | Sangeet Khanna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225298896 PECOS PAC ID: 6204992761 Enrollment ID: I20090804000237 |
| Provider Name | Lyubov Shkarupa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881836443 PECOS PAC ID: 7214051861 Enrollment ID: I20100902000954 |
| Provider Name | Prabash Koneru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033306204 PECOS PAC ID: 1658554191 Enrollment ID: I20181001002977 |
| Provider Name | Juan Almanzar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982707899 PECOS PAC ID: 8224284765 Enrollment ID: I20210708003523 |
| Provider Name | Maria E Laqui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598072100 PECOS PAC ID: 0648504738 Enrollment ID: I20210907002001 |
| Provider Name | Caroline K Hartshorne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003218678 PECOS PAC ID: 7719370071 Enrollment ID: I20220209000326 |
| Provider Name | Graham Brian Farnham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659822278 PECOS PAC ID: 7810382900 Enrollment ID: I20220329000614 |
| Provider Name | Cory Coldwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780091058 PECOS PAC ID: 0840669792 Enrollment ID: I20221215001255 |
| Provider Name | Irena Tsapelas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609464460 PECOS PAC ID: 3274946496 Enrollment ID: I20230309003052 |
| Provider Name | Jennifer Scioscia |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1497353353 PECOS PAC ID: 3870945439 Enrollment ID: I20240118003772 |
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