| Henry Heywood Memorial Hospital | |
|
242 Green St Gardner MA 01440-1336 | |
| (978) 632-3420 | |
| (978) 630-6596 |
| Full Name | Henry Heywood Memorial Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 242 Green St, Gardner, Massachusetts |
| Authorized Official Name and Position | Thomas J Sullivan (CEO) |
| Authorized Official Contact | 9786306157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Henry Heywood Memorial Hospital 242 Green St Gardner MA 01440-1336 Ph: (978) 632-3420 | Henry Heywood Memorial Hospital 242 Green St Gardner MA 01440-1336 Ph: (978) 632-3420 |
| NPI Number | 1205823879 |
|---|---|
| Provider Enumeration Date | 09/29/2005 |
| Last Update Date | 06/08/2023 |
| Certification Date | 06/08/2023 |
| Medicare PECOS PAC ID | 1658262605 |
|---|---|
| Medicare Enrollment ID | O20040322000360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205823879 | NPI | - | NPPES |
| 1000306 | Medicaid | MA | |
| 1200739 | Medicaid | MA |
| Provider Name | Michael D Azzoni |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689661035 PECOS PAC ID: 8426961780 Enrollment ID: I20031112000093 |
| Provider Name | Alice Vaine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164418059 PECOS PAC ID: 9032013883 Enrollment ID: I20031122000072 |
| Provider Name | Salma Batool Anwar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285624916 PECOS PAC ID: 1254230840 Enrollment ID: I20040102000428 |
| Provider Name | James J Sullivan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730161308 PECOS PAC ID: 9638066301 Enrollment ID: I20040228000245 |
| Provider Name | Ruth I Dahlstrom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053372862 PECOS PAC ID: 0042108243 Enrollment ID: I20040309000760 |
| Provider Name | George Krasowski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386627578 PECOS PAC ID: 4284522145 Enrollment ID: I20040310001007 |
| Provider Name | Zafar I. Siddiqui |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134189624 PECOS PAC ID: 6204828973 Enrollment ID: I20040401000906 |
| Provider Name | Daryl R Parker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366435760 PECOS PAC ID: 9830182609 Enrollment ID: I20040407000064 |
| Provider Name | Katy-ann Hannigan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558351635 PECOS PAC ID: 5294720264 Enrollment ID: I20040419000725 |
| Provider Name | Russell D Donnelly |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780672105 PECOS PAC ID: 5193713840 Enrollment ID: I20040503001067 |
| Provider Name | Karl Coyner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609861418 PECOS PAC ID: 8921096322 Enrollment ID: I20040504001234 |
| Provider Name | Stacey Jenee Rutherford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528168135 PECOS PAC ID: 6204825086 Enrollment ID: I20040507000493 |
| Provider Name | Patricia Cross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083646368 PECOS PAC ID: 1557342151 Enrollment ID: I20040601000145 |
| Provider Name | David S Shepro |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1912980947 PECOS PAC ID: 0749262772 Enrollment ID: I20040603000870 |
| Provider Name | Scott D Abel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124020201 PECOS PAC ID: 7517940521 Enrollment ID: I20040610001182 |
| Provider Name | Odalys Croteau |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1588659361 PECOS PAC ID: 3779568233 Enrollment ID: I20040621000509 |
| Provider Name | Liam J Hurley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1093765992 PECOS PAC ID: 4082699400 Enrollment ID: I20040621001086 |
| Provider Name | Tricia L Vorderstrasse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619953247 PECOS PAC ID: 3577541358 Enrollment ID: I20040708001199 |
| Provider Name | Paul I Geraldez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457342958 PECOS PAC ID: 4981684958 Enrollment ID: I20040721000564 |
| Provider Name | Christian G Heinis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447226535 PECOS PAC ID: 1254311020 Enrollment ID: I20040722000423 |
| Provider Name | Robert F Jones |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801871447 PECOS PAC ID: 4981684552 Enrollment ID: I20040723000355 |
| Provider Name | Deborah H Markowitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154490696 PECOS PAC ID: 6103890892 Enrollment ID: I20040819001037 |
| Provider Name | Denise Rainville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376515650 PECOS PAC ID: 4385619147 Enrollment ID: I20040826000779 |
| Provider Name | Francis John Mclaughlin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043300304 PECOS PAC ID: 9830164037 Enrollment ID: I20040831001201 |
| Provider Name | Rodrick A Williams |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427096213 PECOS PAC ID: 4880653963 Enrollment ID: I20041005000613 |
| Provider Name | Wannakuwatte Fernando |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205819281 PECOS PAC ID: 1850351271 Enrollment ID: I20041012000100 |
| Provider Name | Lawrence Proano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265446538 PECOS PAC ID: 8921068214 Enrollment ID: I20041012000673 |
| Provider Name | Peter Dresens |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699750935 PECOS PAC ID: 6002876968 Enrollment ID: I20041014000746 |
| Provider Name | George Abraham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730181876 PECOS PAC ID: 1456314756 Enrollment ID: I20041108000921 |
| Provider Name | Bruce Kenneth Bertrand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215918891 PECOS PAC ID: 1355307315 Enrollment ID: I20041202000188 |
| Provider Name | Stephen M Dierks |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1508857731 PECOS PAC ID: 2163404732 Enrollment ID: I20050125000795 |
| Provider Name | Heather L Archambeault |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285659128 PECOS PAC ID: 4082665187 Enrollment ID: I20050207000337 |
| Provider Name | Heidi J Foley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801981493 PECOS PAC ID: 5799678561 Enrollment ID: I20050222000217 |
| Provider Name | Tina M Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295722072 PECOS PAC ID: 5092769380 Enrollment ID: I20050309000791 |
| Provider Name | Joseph W Walek |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1902891435 PECOS PAC ID: 9931003787 Enrollment ID: I20050328000534 |
| Provider Name | David N Havlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548231731 PECOS PAC ID: 6507842424 Enrollment ID: I20050329001301 |
| Provider Name | Sarah E Gilbert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205915212 PECOS PAC ID: 6608822903 Enrollment ID: I20050330000315 |
| Provider Name | Betsy S August |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346231271 PECOS PAC ID: 5294782512 Enrollment ID: I20050407000945 |
| Provider Name | Alexandra A Schultes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629051396 PECOS PAC ID: 1153368212 Enrollment ID: I20050411001174 |
| Provider Name | Christopher S Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194711523 PECOS PAC ID: 3173560810 Enrollment ID: I20050413001020 |
| Provider Name | Robert J Terlato |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790776730 PECOS PAC ID: 0143267674 Enrollment ID: I20050415000098 |
| Provider Name | Lisa M Rembetsy-brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306811013 PECOS PAC ID: 1254378706 Enrollment ID: I20050415000270 |
| Provider Name | Daniel P Berman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457341794 PECOS PAC ID: 4082651492 Enrollment ID: I20050415000712 |
| Provider Name | Jeffrey D Blake |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992792980 PECOS PAC ID: 2769421106 Enrollment ID: I20050426000858 |
| Provider Name | Mustafa M Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043317845 PECOS PAC ID: 5597706994 Enrollment ID: I20050516000966 |
| Provider Name | Francesco Corvi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649239500 PECOS PAC ID: 9537102421 Enrollment ID: I20050601001056 |
| Provider Name | Daniel John Witkowski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235123845 PECOS PAC ID: 1850334715 Enrollment ID: I20050602000444 |
| Provider Name | Nuzhat Farooqui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689772907 PECOS PAC ID: 7517900012 Enrollment ID: I20050606000962 |
| Provider Name | Lori A Steel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548226939 PECOS PAC ID: 5395780928 Enrollment ID: I20050624000048 |
| Provider Name | Phyllis Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407800550 PECOS PAC ID: 4880652510 Enrollment ID: I20050624000989 |
| Provider Name | Patricia A Koski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710073960 PECOS PAC ID: 2668417049 Enrollment ID: I20050627000244 |
| Provider Name | Geraldine Delisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669865473 PECOS PAC ID: 3577509553 Enrollment ID: I20050629001046 |
| Provider Name | Thomas H Egan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225197569 PECOS PAC ID: 7517997208 Enrollment ID: I20050812000349 |
| Provider Name | Motkar V Reddy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548250657 PECOS PAC ID: 9537199559 Enrollment ID: I20050818000543 |
| Provider Name | Mark E Gale |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174518294 PECOS PAC ID: 9830129758 Enrollment ID: I20050819000298 |
| Provider Name | Cheryl Boissy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568970507 PECOS PAC ID: 1052342425 Enrollment ID: I20050825000328 |
| Provider Name | David H Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316933294 PECOS PAC ID: 3274564570 Enrollment ID: I20050826000146 |
| Provider Name | Mary S Donnelly |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942297528 PECOS PAC ID: 8426089590 Enrollment ID: I20050829000436 |
| Provider Name | Sarah L Crane |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326191032 PECOS PAC ID: 8123059078 Enrollment ID: I20050830000765 |
| Provider Name | Stephen Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427028810 PECOS PAC ID: 2567494933 Enrollment ID: I20050907000197 |
| Provider Name | John Harrington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245229012 PECOS PAC ID: 4880627082 Enrollment ID: I20050917000302 |
| Provider Name | Ellen M Ray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285624353 PECOS PAC ID: 2062446271 Enrollment ID: I20050926001184 |
| Provider Name | Wendy J Coutu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932178167 PECOS PAC ID: 9537194790 Enrollment ID: I20050927001213 |
| Provider Name | Peter Gibson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528028057 PECOS PAC ID: 6305879966 Enrollment ID: I20051004000766 |
| Provider Name | James J Rifino |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679530182 PECOS PAC ID: 3678591799 Enrollment ID: I20051108000196 |
| Provider Name | Ryan A Secan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407865744 PECOS PAC ID: 0446279509 Enrollment ID: I20051117000447 |
| Provider Name | Maria Victoria T Tantengco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679563258 PECOS PAC ID: 3678593902 Enrollment ID: I20051201000734 |
| Provider Name | Steven G Yerid |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265524276 PECOS PAC ID: 6901709799 Enrollment ID: I20060106000609 |
| Provider Name | Christine M Mcmahon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649268277 PECOS PAC ID: 4385658939 Enrollment ID: I20060202000573 |
| Provider Name | Maureen A Kittredge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992939524 PECOS PAC ID: 1254346620 Enrollment ID: I20060207000728 |
| Provider Name | Ahmed K Gayed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184682346 PECOS PAC ID: 7517972722 Enrollment ID: I20060209000162 |
| Provider Name | Louise P Lu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1720008980 PECOS PAC ID: 0143294595 Enrollment ID: I20060301000400 |
| Provider Name | Saleem A Khanani |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1255306643 PECOS PAC ID: 4082622238 Enrollment ID: I20060329000392 |
| Provider Name | Daniel H Ervin |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1376532275 PECOS PAC ID: 8022026228 Enrollment ID: I20060330000013 |
| Provider Name | Dale K Weldon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316004989 PECOS PAC ID: 8628086527 Enrollment ID: I20060404000675 |
| Provider Name | Thomas Dunzendorfer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194786210 PECOS PAC ID: 0446254742 Enrollment ID: I20060829000071 |
| Provider Name | Rositsa D Petrova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497793954 PECOS PAC ID: 9739184482 Enrollment ID: I20061002000307 |
| Provider Name | Juan Vernon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336196674 PECOS PAC ID: 3971509860 Enrollment ID: I20061017000435 |
| Provider Name | Ann Cooper |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265451694 PECOS PAC ID: 7618904079 Enrollment ID: I20061027000261 |
| Provider Name | Yuliya Ostrerov |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437263332 PECOS PAC ID: 8123025103 Enrollment ID: I20061106000077 |
| Provider Name | Anthony J Craig |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477634202 PECOS PAC ID: 7416955315 Enrollment ID: I20061130000345 |
| Provider Name | Madhavi K Toke |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1013985381 PECOS PAC ID: 1254331739 Enrollment ID: I20070106000118 |
| Provider Name | Laura M Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679544712 PECOS PAC ID: 5991737520 Enrollment ID: I20070123000130 |
| Provider Name | Usha Vellayappan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699760538 PECOS PAC ID: 0143322701 Enrollment ID: I20070228000286 |
| Provider Name | Jeffrey Vandall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285714832 PECOS PAC ID: 6608979711 Enrollment ID: I20070310000010 |
| Provider Name | Michael S Stauder |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558383588 PECOS PAC ID: 4284730946 Enrollment ID: I20070426000473 |
| Provider Name | Alexandra Weill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083760805 PECOS PAC ID: 1052218237 Enrollment ID: I20070720000580 |
| Provider Name | Liezl G. Irisari |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851327001 PECOS PAC ID: 7315943297 Enrollment ID: I20070917000143 |
| Provider Name | Martin Ruzek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265411268 PECOS PAC ID: 6406940816 Enrollment ID: I20070917000188 |
| Provider Name | Alexander Zeidel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740248343 PECOS PAC ID: 9739275421 Enrollment ID: I20071010000693 |
| Provider Name | Sandrina Rodrigues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508055427 PECOS PAC ID: 2567550718 Enrollment ID: I20071121000420 |
| Provider Name | Ahmad D Siddiqui |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700873783 PECOS PAC ID: 7315029469 Enrollment ID: I20080128000618 |
| Provider Name | Efran Candelaria |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184801458 PECOS PAC ID: 2860576527 Enrollment ID: I20080220000232 |
| Provider Name | Benjamin D Prentiss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346338274 PECOS PAC ID: 9234218538 Enrollment ID: I20080512000023 |
| Provider Name | Erik Deede |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821036112 PECOS PAC ID: 5092889808 Enrollment ID: I20080728000526 |
| Provider Name | Yousaf A Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417178518 PECOS PAC ID: 8022186758 Enrollment ID: I20081008000624 |
| Provider Name | Elton Fennell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497705891 PECOS PAC ID: 7012950926 Enrollment ID: I20081010000243 |
| Provider Name | Tamer Khafagy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932391422 PECOS PAC ID: 3173681723 Enrollment ID: I20081025000126 |
| Provider Name | Mansoor Anwer Zaidi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861411647 PECOS PAC ID: 2668434374 Enrollment ID: I20081027000805 |
| Provider Name | Iva Gotz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982756557 PECOS PAC ID: 2668531625 Enrollment ID: I20081105000370 |
| Provider Name | Andrew D Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558445825 PECOS PAC ID: 5991864837 Enrollment ID: I20081106000223 |
| Provider Name | Joseph M Barry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578581708 PECOS PAC ID: 3476648551 Enrollment ID: I20081209000522 |
| Provider Name | Gretchen L Kelley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376539346 PECOS PAC ID: 3870654502 Enrollment ID: I20081212000356 |
| Provider Name | April L Cyr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144202664 PECOS PAC ID: 0244392835 Enrollment ID: I20081216000123 |
| Provider Name | Jennifer R Hartman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1861481160 PECOS PAC ID: 4981649225 Enrollment ID: I20090108000794 |
| Provider Name | Sweta Arvind Desai |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1457312654 PECOS PAC ID: 0244289460 Enrollment ID: I20090603000125 |
| Provider Name | Nari Sabeti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720209190 PECOS PAC ID: 6103977814 Enrollment ID: I20090619000119 |
| Provider Name | Tai Lee H Temple |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114971694 PECOS PAC ID: 2961471883 Enrollment ID: I20090622000612 |
| Provider Name | Andrew J Cocchiarella |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376688309 PECOS PAC ID: 4082767355 Enrollment ID: I20090804000349 |
| Provider Name | Rebecca A Zanconato |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689721714 PECOS PAC ID: 7315083581 Enrollment ID: I20091002000028 |
| Provider Name | Christopher Barnes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467603456 PECOS PAC ID: 9638230907 Enrollment ID: I20091019000255 |
| Provider Name | Margo B Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083844773 PECOS PAC ID: 7517005192 Enrollment ID: I20091119000316 |
| Provider Name | Tyanna Barnes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023027513 PECOS PAC ID: 9032114376 Enrollment ID: I20091121000039 |
| Provider Name | Theresa Piotrowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598794505 PECOS PAC ID: 0547227951 Enrollment ID: I20091123000178 |
| Provider Name | Erin C O'hara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942407077 PECOS PAC ID: 2062547136 Enrollment ID: I20100315000263 |
| Provider Name | Melissa Croad |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851623219 PECOS PAC ID: 9931234879 Enrollment ID: I20100317001016 |
| Provider Name | Rozanna Penney |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427372796 PECOS PAC ID: 1153459854 Enrollment ID: I20100517000144 |
| Provider Name | Konstantino Avradopoulos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154390995 PECOS PAC ID: 5294864476 Enrollment ID: I20100526000618 |
| Provider Name | Jacqueline A Tung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255502027 PECOS PAC ID: 3971634080 Enrollment ID: I20100706000055 |
| Provider Name | Mohammad Farivar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831136845 PECOS PAC ID: 1355475708 Enrollment ID: I20100820000181 |
| Provider Name | Joshua Lerner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710184890 PECOS PAC ID: 1153445721 Enrollment ID: I20100903000008 |
| Provider Name | Andrea Damour |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740277730 PECOS PAC ID: 0749473924 Enrollment ID: I20101020000508 |
| Provider Name | Thomas B Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588632723 PECOS PAC ID: 2769452705 Enrollment ID: I20101021000570 |
| Provider Name | Edna Markaddy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396943205 PECOS PAC ID: 3173716107 Enrollment ID: I20101021001139 |
| Provider Name | Marc G Hochler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225045784 PECOS PAC ID: 0244423952 Enrollment ID: I20101026000299 |
| Provider Name | Bret A Ancowitz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962607051 PECOS PAC ID: 6608969175 Enrollment ID: I20101229000684 |
| Provider Name | Maria Abruzzo |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215036132 PECOS PAC ID: 8628266012 Enrollment ID: I20101229000884 |
| Provider Name | Rafael A Meller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881884500 PECOS PAC ID: 4688762040 Enrollment ID: I20110125000332 |
| Provider Name | Michael A Shear |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407016520 PECOS PAC ID: 1658550371 Enrollment ID: I20110127000576 |
| Provider Name | Morris L Rivera |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669440335 PECOS PAC ID: 9133122377 Enrollment ID: I20110204000059 |
| Provider Name | Sarah R Leonard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588862494 PECOS PAC ID: 1153505532 Enrollment ID: I20110408000402 |
| Provider Name | Alison G Willnow |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245535137 PECOS PAC ID: 6608051065 Enrollment ID: I20110428000274 |
| Provider Name | Mudita Gogna |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1235391640 PECOS PAC ID: 7416133111 Enrollment ID: I20110513000413 |
| Provider Name | Charles D Allison |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316118193 PECOS PAC ID: 6103004288 Enrollment ID: I20110620000160 |
| Provider Name | Kwesi A Ntiforo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730345794 PECOS PAC ID: 0042356693 Enrollment ID: I20110718000100 |
| Provider Name | Alexandra Evindar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881859072 PECOS PAC ID: 0244408623 Enrollment ID: I20110801000039 |
| Provider Name | Vikram P Narayan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265600928 PECOS PAC ID: 1254401003 Enrollment ID: I20110810000017 |
| Provider Name | Patrick T. Hook |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1548420896 PECOS PAC ID: 1052582343 Enrollment ID: I20110916000364 |
| Provider Name | Kalyan Kalava |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881870400 PECOS PAC ID: 8022180652 Enrollment ID: I20111007000141 |
| Provider Name | Daniel Salter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669467486 PECOS PAC ID: 4688848021 Enrollment ID: I20111121000191 |
| Provider Name | Kevin Stone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669459731 PECOS PAC ID: 3678731130 Enrollment ID: I20120301000101 |
| Provider Name | Adam C Darnobid |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194950899 PECOS PAC ID: 3274792411 Enrollment ID: I20120308000163 |
| Provider Name | Christopher J Breen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699790121 PECOS PAC ID: 9739146440 Enrollment ID: I20120917000536 |
| Provider Name | David Nesanelis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518287416 PECOS PAC ID: 8820246721 Enrollment ID: I20120919000094 |
| Provider Name | Jasper I Ngomba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760620975 PECOS PAC ID: 2163548066 Enrollment ID: I20120924000657 |
| Provider Name | Katherine E Fitzgerald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134357346 PECOS PAC ID: 0244480341 Enrollment ID: I20121026000219 |
| Provider Name | Jared A Toman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1912173071 PECOS PAC ID: 9335321512 Enrollment ID: I20121221000165 |
| Provider Name | Michael A Kramer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760412613 PECOS PAC ID: 9537124045 Enrollment ID: I20130103000372 |
| Provider Name | Jonathan E Grogins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396897971 PECOS PAC ID: 1254584782 Enrollment ID: I20130114000203 |
| Provider Name | Elizabeth Atlee Menefee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326393646 PECOS PAC ID: 0446404479 Enrollment ID: I20130129000190 |
| Provider Name | David M Koenig |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972849404 PECOS PAC ID: 5496990541 Enrollment ID: I20130321000069 |
| Provider Name | Imola Daniel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245460609 PECOS PAC ID: 3870733207 Enrollment ID: I20130709000240 |
| Provider Name | Annette R Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033442686 PECOS PAC ID: 8921278466 Enrollment ID: I20130718000665 |
| Provider Name | Sarah K Lamoreaux |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982042958 PECOS PAC ID: 0345482113 Enrollment ID: I20130806000935 |
| Provider Name | James Phillips |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952423188 PECOS PAC ID: 7618112970 Enrollment ID: I20130814000229 |
| Provider Name | Ronald S Matteotti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356546683 PECOS PAC ID: 9739238742 Enrollment ID: I20130911000814 |
| Provider Name | Deborah A Corson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952508202 PECOS PAC ID: 4789822685 Enrollment ID: I20130912000452 |
| Provider Name | Ritu Rani Sarin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801112198 PECOS PAC ID: 5496999781 Enrollment ID: I20130927000039 |
| Provider Name | Keshav Parthasarathy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447401419 PECOS PAC ID: 3375788748 Enrollment ID: I20131008001413 |
| Provider Name | Amy Beth Heroux |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700228590 PECOS PAC ID: 7315172087 Enrollment ID: I20131105001322 |
| Provider Name | Jessica P Simons |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1669527479 PECOS PAC ID: 7517192180 Enrollment ID: I20131107000549 |
| Provider Name | Yi-lo Yu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194952838 PECOS PAC ID: 8123255692 Enrollment ID: I20131209001701 |
| Provider Name | Mahmoud Sakr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861650681 PECOS PAC ID: 5799828307 Enrollment ID: I20140207000591 |
| Provider Name | Erin E Dacey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003246190 PECOS PAC ID: 7911120027 Enrollment ID: I20140519000442 |
| Provider Name | Marie G Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215376405 PECOS PAC ID: 6507080314 Enrollment ID: I20140618001161 |
| Provider Name | Jessica A Darnobid |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124339551 PECOS PAC ID: 1658598222 Enrollment ID: I20140806001007 |
| Provider Name | Javad T Hashmi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861710840 PECOS PAC ID: 6002035268 Enrollment ID: I20140919002131 |
| Provider Name | Helen Braig Heneghan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427120476 PECOS PAC ID: 2264402486 Enrollment ID: I20140922002083 |
| Provider Name | Maurine J Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669766879 PECOS PAC ID: 7012138175 Enrollment ID: I20141015001058 |
| Provider Name | Sara Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730588989 PECOS PAC ID: 6901027721 Enrollment ID: I20141021000544 |
| Provider Name | Carol Reich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366854481 PECOS PAC ID: 3173845260 Enrollment ID: I20141126001253 |
| Provider Name | Jaime Walker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598171019 PECOS PAC ID: 2264757145 Enrollment ID: I20150218000137 |
| Provider Name | Jacob Emanuel Bevilacqua |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992048870 PECOS PAC ID: 4688809908 Enrollment ID: I20150314000225 |
| Provider Name | Joseph M Litwak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396792958 PECOS PAC ID: 0648367722 Enrollment ID: I20150321000081 |
| Provider Name | Sari Miettinen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790896355 PECOS PAC ID: 2365544319 Enrollment ID: I20150515001478 |
| Provider Name | Ashley R Didonna |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154725836 PECOS PAC ID: 5890016042 Enrollment ID: I20150601000726 |
| Provider Name | Kenneth M Sicard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093965436 PECOS PAC ID: 1052538360 Enrollment ID: I20150608000335 |
| Provider Name | Nisha M David |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851689988 PECOS PAC ID: 9436381118 Enrollment ID: I20150710000533 |
| Provider Name | Steven Bbuye |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780943506 PECOS PAC ID: 9436473766 Enrollment ID: I20150805009402 |
| Provider Name | Phani Molakatalla |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861620007 PECOS PAC ID: 1658518352 Enrollment ID: I20150820010165 |
| Provider Name | Paul E Daniel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104187400 PECOS PAC ID: 1153553235 Enrollment ID: I20150902000618 |
| Provider Name | Tiffany Lynne Rhodes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083028716 PECOS PAC ID: 0941428742 Enrollment ID: I20150918000444 |
| Provider Name | Shahzad W Khan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396004024 PECOS PAC ID: 2860715950 Enrollment ID: I20151104002513 |
| Provider Name | Mariyan Montaque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083081046 PECOS PAC ID: 1850692708 Enrollment ID: I20151217001450 |
| Provider Name | Alicia C Radzicki |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558743286 PECOS PAC ID: 7911200464 Enrollment ID: I20160118000383 |
| Provider Name | Aimee St Hilaire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740657576 PECOS PAC ID: 9133422801 Enrollment ID: I20160129001797 |
| Provider Name | Kenya Hanspard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932170305 PECOS PAC ID: 9739072984 Enrollment ID: I20160318000840 |
| Provider Name | Daniel Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437179074 PECOS PAC ID: 5799858403 Enrollment ID: I20160405000551 |
| Provider Name | Alok K Sinha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942443098 PECOS PAC ID: 0749326890 Enrollment ID: I20160405001674 |
| Provider Name | Gueorgui D Dimov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659488757 PECOS PAC ID: 5698868982 Enrollment ID: I20160504000722 |
| Provider Name | Melanie J Teabo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528431830 PECOS PAC ID: 8022307859 Enrollment ID: I20160518001932 |
| Provider Name | Craig Anthony Napolitano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962726919 PECOS PAC ID: 7719285279 Enrollment ID: I20160610000876 |
| Provider Name | Swati R Dhanireddy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740620426 PECOS PAC ID: 5496987455 Enrollment ID: I20160921000628 |
| Provider Name | Sukhshant Atti |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306272141 PECOS PAC ID: 3779870316 Enrollment ID: I20160924000111 |
| Provider Name | Tatsuyoshi Kitamura |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740629682 PECOS PAC ID: 4486941010 Enrollment ID: I20160927000106 |
| Provider Name | Felix R Szabo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669714051 PECOS PAC ID: 7012209612 Enrollment ID: I20161010001544 |
| Provider Name | Jasmine S Mathews |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588922900 PECOS PAC ID: 3678799301 Enrollment ID: I20161010002236 |
| Provider Name | Catharine Mary Armentrout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275834061 PECOS PAC ID: 7113238916 Enrollment ID: I20161020001869 |
| Provider Name | Thomas Albert Scalfarotto |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003128067 PECOS PAC ID: 9436372422 Enrollment ID: I20161021000095 |
| Provider Name | Douglas Romney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184059735 PECOS PAC ID: 9830326305 Enrollment ID: I20161027001114 |
| Provider Name | Eric Francis Swart |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386960128 PECOS PAC ID: 8820304918 Enrollment ID: I20161114001248 |
| Provider Name | Juffred V Colon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477008563 PECOS PAC ID: 9133408107 Enrollment ID: I20161115000687 |
| Provider Name | Taylor K Boudreau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437502630 PECOS PAC ID: 0042599664 Enrollment ID: I20161122000660 |
| Provider Name | Vladislav I Troshin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396198420 PECOS PAC ID: 5193004729 Enrollment ID: I20161122000912 |
| Provider Name | Andrea D Julian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528347457 PECOS PAC ID: 0547549123 Enrollment ID: I20161123000492 |
| Provider Name | Douglas C Campbell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184872335 PECOS PAC ID: 3173839040 Enrollment ID: I20170207000400 |
| Provider Name | Abby L Brockelbank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043694656 PECOS PAC ID: 0345541447 Enrollment ID: I20170315000724 |
| Provider Name | Julie Ann Pelletier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649718198 PECOS PAC ID: 8426335126 Enrollment ID: I20170508000049 |
| Provider Name | Pamela Jean Sansoucy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982022935 PECOS PAC ID: 1951527290 Enrollment ID: I20170713001601 |
| Provider Name | Matthew J Clifford |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083153969 PECOS PAC ID: 5496026700 Enrollment ID: I20170804001613 |
| Provider Name | Amit Kumar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619381621 PECOS PAC ID: 5799904629 Enrollment ID: I20170818000289 |
| Provider Name | Christina Morse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346764743 PECOS PAC ID: 7113293523 Enrollment ID: I20171030000875 |
| Provider Name | Phyllis Chinyanga-edouard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295261782 PECOS PAC ID: 2961760160 Enrollment ID: I20171218000013 |
| Provider Name | Kristina Gallant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235657289 PECOS PAC ID: 6507125838 Enrollment ID: I20180112001610 |
| Provider Name | Kimberly Lyn Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134634520 PECOS PAC ID: 5496014268 Enrollment ID: I20180124001827 |
| Provider Name | Benjamin Fakharzadeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689801391 PECOS PAC ID: 1052621240 Enrollment ID: I20180315000803 |
| Provider Name | Steven Tourangeau |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851335632 PECOS PAC ID: 1153326202 Enrollment ID: I20180327000604 |
| Provider Name | Jessica Leblanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467964288 PECOS PAC ID: 9537421540 Enrollment ID: I20180402000834 |
| Provider Name | Armand S. Vargas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689180952 PECOS PAC ID: 0840554341 Enrollment ID: I20180509002276 |
| Provider Name | Hilary M Dulin Sauta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790202885 PECOS PAC ID: 7618231994 Enrollment ID: I20180515000376 |
| Provider Name | Cory Michael Nohl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184880569 PECOS PAC ID: 9638361082 Enrollment ID: I20180606002269 |
| Provider Name | Shameen Wijesundara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801283759 PECOS PAC ID: 5698083830 Enrollment ID: I20180621001847 |
| Provider Name | Shawn Anthony Berkowitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063479798 PECOS PAC ID: 7618999129 Enrollment ID: I20180710001296 |
| Provider Name | Karim G Sabeh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134461965 PECOS PAC ID: 4880941921 Enrollment ID: I20180720001784 |
| Provider Name | Jiri Brabec |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093944332 PECOS PAC ID: 1153564299 Enrollment ID: I20180801000908 |
| Provider Name | Rachael Elizabeth Greenleaf |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558847525 PECOS PAC ID: 7618225384 Enrollment ID: I20180813002296 |
| Provider Name | Hanna Yapikhina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902385560 PECOS PAC ID: 6305196155 Enrollment ID: I20180829001559 |
| Provider Name | Kelly A Robinson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942266549 PECOS PAC ID: 1759483233 Enrollment ID: I20180928000466 |
| Provider Name | Victoria Abbie Valeri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164773149 PECOS PAC ID: 6709138886 Enrollment ID: I20181018001070 |
| Provider Name | Jessica Goodfield-stelmokas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508010208 PECOS PAC ID: 7416200472 Enrollment ID: I20181022002753 |
| Provider Name | Chuncie Rena Willis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598166365 PECOS PAC ID: 8820340458 Enrollment ID: I20181025002670 |
| Provider Name | Mukti J Patel-prineas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083932990 PECOS PAC ID: 0840439840 Enrollment ID: I20181030002821 |
| Provider Name | Afia F. Mirza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962804096 PECOS PAC ID: 9537380712 Enrollment ID: I20181031001459 |
| Provider Name | Maireni R Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821228727 PECOS PAC ID: 3274679998 Enrollment ID: I20181107002408 |
| Provider Name | Amy L Moran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487942116 PECOS PAC ID: 2860739489 Enrollment ID: I20190121000759 |
| Provider Name | Jennifer Park |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265908602 PECOS PAC ID: 5597004846 Enrollment ID: I20190304001243 |
| Provider Name | Megan V. Collins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275001893 PECOS PAC ID: 3476892555 Enrollment ID: I20190307001377 |
| Provider Name | Joseph William Marchese |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457694671 PECOS PAC ID: 5294037339 Enrollment ID: I20190723000896 |
| Provider Name | Vinod Mohan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1326351594 PECOS PAC ID: 5597071464 Enrollment ID: I20190801000827 |
| Provider Name | Meghan L Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700348380 PECOS PAC ID: 5597092981 Enrollment ID: I20190807003510 |
| Provider Name | Daniel Banaszek |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487114377 PECOS PAC ID: 8921338989 Enrollment ID: I20190918001726 |
| Provider Name | Benjamin J Brill |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609202555 PECOS PAC ID: 7517215403 Enrollment ID: I20190930002429 |
| Provider Name | Milinda Ruth Carson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275572034 PECOS PAC ID: 6305804659 Enrollment ID: I20191213000088 |
| Provider Name | Catherine Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093359895 PECOS PAC ID: 8123455367 Enrollment ID: I20200227001196 |
| Provider Name | Timothy J. Boardman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245687755 PECOS PAC ID: 7810282076 Enrollment ID: I20200302001827 |
| Provider Name | Erin Kate Dooley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215199542 PECOS PAC ID: 5193902328 Enrollment ID: I20200415001627 |
| Provider Name | Cerena Dime |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699300855 PECOS PAC ID: 9234569864 Enrollment ID: I20200423000581 |
| Provider Name | Sanjeevani Deolapure |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306009717 PECOS PAC ID: 4183884430 Enrollment ID: I20200423002832 |
| Provider Name | Elizabeth Tateoka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427505155 PECOS PAC ID: 9234410267 Enrollment ID: I20200518001145 |
| Provider Name | Matthew Moore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962823229 PECOS PAC ID: 3577855105 Enrollment ID: I20200622001370 |
| Provider Name | Christina M Bordeau |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1750605259 PECOS PAC ID: 8325343700 Enrollment ID: I20200624000453 |
| Provider Name | Brandon Dube |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033732094 PECOS PAC ID: 7113344359 Enrollment ID: I20200902000877 |
| Provider Name | Joseph Wollman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134563489 PECOS PAC ID: 3476855768 Enrollment ID: I20200909000562 |
| Provider Name | Casey Melissa Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417595331 PECOS PAC ID: 0547689499 Enrollment ID: I20200928000927 |
| Provider Name | Brian Matthew Danshaw |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013301894 PECOS PAC ID: 0648547141 Enrollment ID: I20201006002258 |
| Provider Name | Joanne Butterfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194215749 PECOS PAC ID: 0840610606 Enrollment ID: I20201015002490 |
| Provider Name | Kristy Marie Grainger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740890573 PECOS PAC ID: 8820409873 Enrollment ID: I20201123001442 |
| Provider Name | Tamara Elizabeth Perini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477943637 PECOS PAC ID: 1355752916 Enrollment ID: I20201203000331 |
| Provider Name | Leslie Pacobahyba-levin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295247260 PECOS PAC ID: 3971862871 Enrollment ID: I20210122000811 |
| Provider Name | Annabi I Djalo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437311289 PECOS PAC ID: 6204900186 Enrollment ID: I20210305001264 |
| Provider Name | Tina S Nelson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639182322 PECOS PAC ID: 2264337682 Enrollment ID: I20210330000105 |
| Provider Name | Victoria Edwards |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932540077 PECOS PAC ID: 6002164977 Enrollment ID: I20210526000378 |
| Provider Name | Jillian Wiseman Bates |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245808120 PECOS PAC ID: 2163825258 Enrollment ID: I20210727003102 |
| Provider Name | Peter Wertheimer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922201730 PECOS PAC ID: 0547357923 Enrollment ID: I20210820000103 |
| Provider Name | Andrew James Mostello |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124454822 PECOS PAC ID: 0446503916 Enrollment ID: I20210929002110 |
| Provider Name | Melissa Vaine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689240038 PECOS PAC ID: 0840688180 Enrollment ID: I20211019002398 |
| Provider Name | Paula Trigo Blanco |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871884452 PECOS PAC ID: 5890085567 Enrollment ID: I20211101002531 |
| Provider Name | David Edwards |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326342262 PECOS PAC ID: 4587835962 Enrollment ID: I20220124002605 |
| Provider Name | Susanna Tierney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225106040 PECOS PAC ID: 0941304083 Enrollment ID: I20220128000695 |
| Provider Name | Sophia Van Hoff |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366769960 PECOS PAC ID: 9638390545 Enrollment ID: I20220401002031 |
| Provider Name | Rafael Montecino |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821175316 PECOS PAC ID: 2062651599 Enrollment ID: I20220518001678 |
| Provider Name | Samuel M Hall |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568881498 PECOS PAC ID: 8325338064 Enrollment ID: I20220815001625 |
| Provider Name | Jason Greenbaum |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649205493 PECOS PAC ID: 7517963390 Enrollment ID: I20220815002214 |
| Provider Name | James Kim |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073995486 PECOS PAC ID: 3779959192 Enrollment ID: I20221026000613 |
| Provider Name | Rudolf Gausling |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811060668 PECOS PAC ID: 2769412444 Enrollment ID: I20230124002654 |
| Provider Name | Brenda A Nyamogo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912325176 PECOS PAC ID: 9436376530 Enrollment ID: I20230207002672 |
| Provider Name | Chelsea Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821546813 PECOS PAC ID: 8426421298 Enrollment ID: I20230224001721 |
| Provider Name | Monica Mbugua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821700493 PECOS PAC ID: 4981078243 Enrollment ID: I20230328001863 |
| Provider Name | Joana Folayan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730119041 PECOS PAC ID: 6204938236 Enrollment ID: I20231005002682 |
| Provider Name | Katherine Nyren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841638129 PECOS PAC ID: 2062858897 Enrollment ID: I20240314002269 |
| Provider Name | Olivia Rose Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669252771 PECOS PAC ID: 7315383056 Enrollment ID: I20240315002490 |
| Provider Name | Sean Reid |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386201911 PECOS PAC ID: 9931432168 Enrollment ID: I20240326003724 |
| Provider Name | Aparna Panja |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881215135 PECOS PAC ID: 4284072067 Enrollment ID: I20240401000112 |
| Provider Name | Sherry Lillian Rickan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093426934 PECOS PAC ID: 7214376516 Enrollment ID: I20240419000807 |
| Provider Name | Hanish Jain |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518443019 PECOS PAC ID: 9234476839 Enrollment ID: I20240507002012 |
| Provider Name | Denise Marie Arcand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649291527 PECOS PAC ID: 6305848615 Enrollment ID: I20240510003340 |
| Provider Name | Morgan Ban-draoi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952601734 PECOS PAC ID: 5294176566 Enrollment ID: I20240517000571 |
| Provider Name | Rebecca Ann Blodgett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205153780 PECOS PAC ID: 5799126934 Enrollment ID: I20240518000020 |
| Provider Name | Zachary Welsh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770158016 PECOS PAC ID: 2062854482 Enrollment ID: I20240530000889 |
| Provider Name | Kristin J Gingras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669171708 PECOS PAC ID: 7719429117 Enrollment ID: I20240612002430 |
| Provider Name | Tiffany A Landry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245887801 PECOS PAC ID: 4587107859 Enrollment ID: I20240615000103 |
| Provider Name | Vasu Babu Dhulipala |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588015093 PECOS PAC ID: 0143516815 Enrollment ID: I20240708002819 |
| Provider Name | Jennifer M Bruinsma |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245515998 PECOS PAC ID: 7214472273 Enrollment ID: I20240715000796 |
| Provider Name | Jennifer Lynn Trites |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730229667 PECOS PAC ID: 3678018637 Enrollment ID: I20240715000821 |
| Provider Name | Allison C Goulet-scott |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750917621 PECOS PAC ID: 1052731338 Enrollment ID: I20240730000104 |
| Provider Name | Tomasz G Michalewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588606792 PECOS PAC ID: 9638181357 Enrollment ID: I20240829002831 |
| Provider Name | Dalina Hanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982304028 PECOS PAC ID: 9739614884 Enrollment ID: I20241126001181 |
| Provider Name | Ezinnem Ugoji |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851913081 PECOS PAC ID: 1052722667 Enrollment ID: I20241202001515 |
Youth Opportunites Uphelp, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 School St, Gardner, MA 01440 Phone: 978-630-4918 | |
Sparks Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Mechanic St, Gardner, MA 01440 Phone: 508-963-9526 | |
Full-circle Coaching Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Sunset Rd, Gardner, MA 01440 Phone: 978-751-4046 | |
Anchored Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 26 Olde Colonial Dr Apt 2, Gardner, MA 01440 Phone: 978-806-3009 | |
Henry Heywood Memorial Hospital Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 242 Green St, Gardner, MA 01440 Phone: 978-632-3420 Fax: 978-630-6596 | |
Joel Silver Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 31 Lake St, Suite 101, Gardner, MA 01440 Phone: 978-632-4516 |