| Medical Group | |
|
71 Haynes St Miller Bldg., Floor G Manchester CT 06040-4131 | |
| (860) 533-2981 | |
| (860) 533-2975 |
| Full Name | Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 71 Haynes St, Manchester, Connecticut |
| Authorized Official Name and Position | Robert Jon Elders (SECRETARY) |
| Authorized Official Contact | 7147881249 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Group 71 Haynes St Miller Bldg., Floor G Manchester CT 06040-4131 Ph: (860) 533-2981 | Medical Group 71 Haynes St Miller Bldg., Floor G Manchester CT 06040-4131 Ph: (860) 533-2981 |
| NPI Number | 1144677568 |
|---|---|
| Provider Enumeration Date | 05/16/2016 |
| Last Update Date | 03/15/2021 |
| Certification Date | 03/15/2021 |
| Medicare PECOS PAC ID | 7416244496 |
|---|---|
| Medicare Enrollment ID | O20160919001322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144677568 | NPI | - | NPPES |
| Provider Name | Michael G Zerbe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952361453 PECOS PAC ID: 8921902776 Enrollment ID: I20031122000087 |
| Provider Name | Cynthia Marie Grindle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982682092 PECOS PAC ID: 5991602336 Enrollment ID: I20031215000715 |
| Provider Name | Ellen G Neuhaus |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1558330720 PECOS PAC ID: 2466351895 Enrollment ID: I20040106000068 |
| Provider Name | Doreen a Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871509968 PECOS PAC ID: 7618877291 Enrollment ID: I20040110000120 |
| Provider Name | Leonard Koliani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619995677 PECOS PAC ID: 0244123487 Enrollment ID: I20040203000605 |
| Provider Name | Arthur L Lebowitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205851169 PECOS PAC ID: 0345133591 Enrollment ID: I20040203000654 |
| Provider Name | Joseph P Deluca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629090071 PECOS PAC ID: 4688567845 Enrollment ID: I20040203000674 |
| Provider Name | Joseph P Morley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053349407 PECOS PAC ID: 3274429147 Enrollment ID: I20040226000588 |
| Provider Name | Lynn J Phillips |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801869706 PECOS PAC ID: 5092602623 Enrollment ID: I20040301000060 |
| Provider Name | Dennis Burke |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1508975798 PECOS PAC ID: 8426948522 Enrollment ID: I20040319000830 |
| Provider Name | Ruth E Weissberger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255365326 PECOS PAC ID: 8325930746 Enrollment ID: I20040329001057 |
| Provider Name | Michael P Bey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992777544 PECOS PAC ID: 0941293625 Enrollment ID: I20040407000900 |
| Provider Name | Eugene M Ciccone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437114030 PECOS PAC ID: 3476540766 Enrollment ID: I20040428001107 |
| Provider Name | Jonathan J Fillmore |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1578592713 PECOS PAC ID: 5991789661 Enrollment ID: I20040618000091 |
| Provider Name | Dushyant N Gandhi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689683138 PECOS PAC ID: 4789662008 Enrollment ID: I20040712001318 |
| Provider Name | Anita L Salerno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407821184 PECOS PAC ID: 0446222392 Enrollment ID: I20040811000036 |
| Provider Name | Leor Zedek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427000538 PECOS PAC ID: 9133193220 Enrollment ID: I20040824000871 |
| Provider Name | Joan M Doback |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902888936 PECOS PAC ID: 9133198567 Enrollment ID: I20041001000125 |
| Provider Name | Geoffrey E Ferrucci |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144314311 PECOS PAC ID: 3173584299 Enrollment ID: I20041022000121 |
| Provider Name | Faria a Mahmood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427020080 PECOS PAC ID: 3870555899 Enrollment ID: I20041102000525 |
| Provider Name | Jill M Zabit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689648453 PECOS PAC ID: 6608839998 Enrollment ID: I20041108000864 |
| Provider Name | Bridget M Mccue |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588743462 PECOS PAC ID: 9032174156 Enrollment ID: I20041130000717 |
| Provider Name | Shiven B Chabria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932172830 PECOS PAC ID: 5395794853 Enrollment ID: I20050121000626 |
| Provider Name | David J Pizzuto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417989096 PECOS PAC ID: 5698725638 Enrollment ID: I20050127000012 |
| Provider Name | Yelena Titko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518980473 PECOS PAC ID: 6406800614 Enrollment ID: I20050310000517 |
| Provider Name | Kimberly B Collins |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1417926296 PECOS PAC ID: 9638124225 Enrollment ID: I20050316000750 |
| Provider Name | Chandra K Sacheti |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124087655 PECOS PAC ID: 6800865247 Enrollment ID: I20050317000528 |
| Provider Name | Karen B Renstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457437428 PECOS PAC ID: 1052366564 Enrollment ID: I20050317000578 |
| Provider Name | David M Bass |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1497722300 PECOS PAC ID: 3678511979 Enrollment ID: I20050418001207 |
| Provider Name | Yasmine Khan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1972577518 PECOS PAC ID: 2860432184 Enrollment ID: I20050505001044 |
| Provider Name | Christopher a Cavanna |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669524526 PECOS PAC ID: 7810937711 Enrollment ID: I20050510001058 |
| Provider Name | Ehsan Ansari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841236312 PECOS PAC ID: 5698719045 Enrollment ID: I20050616000095 |
| Provider Name | Jo-anne a Cosgriff |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942224902 PECOS PAC ID: 0143265124 Enrollment ID: I20050621000323 |
| Provider Name | Scott E Harrison |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356343966 PECOS PAC ID: 1557307592 Enrollment ID: I20050630000146 |
| Provider Name | Daniel S Fusco |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1245235936 PECOS PAC ID: 8325074958 Enrollment ID: I20050714000378 |
| Provider Name | Michael J Nolan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386664787 PECOS PAC ID: 9234166356 Enrollment ID: I20050720000885 |
| Provider Name | Al O Giwa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083689673 PECOS PAC ID: 2567434681 Enrollment ID: I20050831000188 |
| Provider Name | Roula G Rizk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265440986 PECOS PAC ID: 3072547843 Enrollment ID: I20050921000445 |
| Provider Name | Jay D Kenkare |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1619940996 PECOS PAC ID: 5991730731 Enrollment ID: I20050930000207 |
| Provider Name | Stephanie a Birn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922033364 PECOS PAC ID: 2860412657 Enrollment ID: I20051122000644 |
| Provider Name | Monika Hoang-skawinska |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063427599 PECOS PAC ID: 9830119478 Enrollment ID: I20051129000219 |
| Provider Name | Martin J Kelly |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447300702 PECOS PAC ID: 9931129996 Enrollment ID: I20051206000155 |
| Provider Name | Mary L Aquavia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982791547 PECOS PAC ID: 8123040193 Enrollment ID: I20051220000071 |
| Provider Name | Mary C Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063487106 PECOS PAC ID: 6305869892 Enrollment ID: I20060111000193 |
| Provider Name | Denise L Filosi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245299189 PECOS PAC ID: 1355356205 Enrollment ID: I20060214000068 |
| Provider Name | Omaira Velez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942227772 PECOS PAC ID: 0648288027 Enrollment ID: I20060327000375 |
| Provider Name | George M Barchini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023094133 PECOS PAC ID: 1557372240 Enrollment ID: I20060509000687 |
| Provider Name | Shikha M. Sarkar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942251814 PECOS PAC ID: 4587645650 Enrollment ID: I20060710000181 |
| Provider Name | Susan C Izzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881644631 PECOS PAC ID: 9234142373 Enrollment ID: I20060713000233 |
| Provider Name | Franco Galasso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174573539 PECOS PAC ID: 9032122759 Enrollment ID: I20060725000443 |
| Provider Name | Ralph V Tremaglio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053360305 PECOS PAC ID: 1052324431 Enrollment ID: I20060802000031 |
| Provider Name | Sohrab Zahedi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457371049 PECOS PAC ID: 2466455845 Enrollment ID: I20060825000135 |
| Provider Name | Lesley a Gustafson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1639163199 PECOS PAC ID: 7517961188 Enrollment ID: I20060913000303 |
| Provider Name | Richard M Shoup |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518930957 PECOS PAC ID: 9133125024 Enrollment ID: I20061017000403 |
| Provider Name | Mark Tabaka |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457353005 PECOS PAC ID: 1759388945 Enrollment ID: I20061101000035 |
| Provider Name | Christine R Dunbar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194773358 PECOS PAC ID: 9830196880 Enrollment ID: I20061103000403 |
| Provider Name | Allan R Mayer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437153012 PECOS PAC ID: 0345248910 Enrollment ID: I20061114000287 |
| Provider Name | Sagar M Phatak |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1023033149 PECOS PAC ID: 2961400130 Enrollment ID: I20061122000297 |
| Provider Name | Ionut B Anton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770550238 PECOS PAC ID: 8729086855 Enrollment ID: I20061127000326 |
| Provider Name | Abdul M Sheikh |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1992799829 PECOS PAC ID: 0446285647 Enrollment ID: I20070102000236 |
| Provider Name | Rhianon N Iassogna Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457422057 PECOS PAC ID: 1456351022 Enrollment ID: I20070104000214 |
| Provider Name | Alexia Thomas Koudellou |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346278066 PECOS PAC ID: 6204822802 Enrollment ID: I20070123000309 |
| Provider Name | Jessica M Grant |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376527085 PECOS PAC ID: 2860441466 Enrollment ID: I20070315000346 |
| Provider Name | Andrew a Kronk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427006642 PECOS PAC ID: 8729185178 Enrollment ID: I20070518000214 |
| Provider Name | Lisa M Oliveira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467514513 PECOS PAC ID: 1153429345 Enrollment ID: I20070612000576 |
| Provider Name | Raghuraman R Vidhun |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578680062 PECOS PAC ID: 9032210901 Enrollment ID: I20070723000014 |
| Provider Name | Michael a Harma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710106547 PECOS PAC ID: 7214029081 Enrollment ID: I20070824000145 |
| Provider Name | Remi Mathews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407054794 PECOS PAC ID: 6709978505 Enrollment ID: I20070824000377 |
| Provider Name | Jonathan D Parkhurst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164628889 PECOS PAC ID: 5991899403 Enrollment ID: I20070914000172 |
| Provider Name | Elizabeth C Riordan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528078995 PECOS PAC ID: 9234223306 Enrollment ID: I20070920000020 |
| Provider Name | Swarupa R Vedere |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770703423 PECOS PAC ID: 8325134422 Enrollment ID: I20071022000096 |
| Provider Name | Neil J Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154370401 PECOS PAC ID: 8123116829 Enrollment ID: I20071114000039 |
| Provider Name | Joshua R Miles |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790972347 PECOS PAC ID: 5799874152 Enrollment ID: I20071207000684 |
| Provider Name | Booth Wainscoat |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1699707141 PECOS PAC ID: 7012912165 Enrollment ID: I20071214000550 |
| Provider Name | Danny a Korkmaz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699967349 PECOS PAC ID: 5597845289 Enrollment ID: I20080108000206 |
| Provider Name | Amy L Fraser |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659568715 PECOS PAC ID: 3476563487 Enrollment ID: I20080109000804 |
| Provider Name | Danielle Waite |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578759882 PECOS PAC ID: 7618058413 Enrollment ID: I20080118000076 |
| Provider Name | Deann C Masterson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427230804 PECOS PAC ID: 9133202807 Enrollment ID: I20080219000317 |
| Provider Name | Greta Boynton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801854773 PECOS PAC ID: 9234156878 Enrollment ID: I20080220000055 |
| Provider Name | Christopher M Maio |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497939532 PECOS PAC ID: 9032294715 Enrollment ID: I20080305000113 |
| Provider Name | Christina Cipriani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871699181 PECOS PAC ID: 6002992146 Enrollment ID: I20080328000598 |
| Provider Name | Nieves Hornbeck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780635771 PECOS PAC ID: 0648249862 Enrollment ID: I20080401000043 |
| Provider Name | Mario Rodenas |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1871709063 PECOS PAC ID: 9739279852 Enrollment ID: I20080415000095 |
| Provider Name | Ferdinando Urbano |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053599902 PECOS PAC ID: 5799864161 Enrollment ID: I20080509000552 |
| Provider Name | Leonard I Eisenfeld |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649243379 PECOS PAC ID: 5496826554 Enrollment ID: I20080617000361 |
| Provider Name | John P Moschello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073592978 PECOS PAC ID: 1850463415 Enrollment ID: I20080626000623 |
| Provider Name | Socorro Vargas |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588774244 PECOS PAC ID: 3678646221 Enrollment ID: I20080716000031 |
| Provider Name | Richard C Orris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033186598 PECOS PAC ID: 8022181015 Enrollment ID: I20080724000271 |
| Provider Name | Jonathan D Mosovich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851578660 PECOS PAC ID: 8123192952 Enrollment ID: I20080728000791 |
| Provider Name | T Michelle G Mariani |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740303544 PECOS PAC ID: 5991870453 Enrollment ID: I20080818000475 |
| Provider Name | Hazar Dahhan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023077609 PECOS PAC ID: 7517031206 Enrollment ID: I20080930000129 |
| Provider Name | Peter Scott Nelson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083862122 PECOS PAC ID: 7416967591 Enrollment ID: I20081030000006 |
| Provider Name | Joseph E Podolski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225221732 PECOS PAC ID: 3870653041 Enrollment ID: I20081118000183 |
| Provider Name | Juliet E Rivera |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033191028 PECOS PAC ID: 0143380816 Enrollment ID: I20081125000765 |
| Provider Name | Steven D Kaufmann |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700868056 PECOS PAC ID: 9830259522 Enrollment ID: I20081126000122 |
| Provider Name | Stacy D Holtz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487637674 PECOS PAC ID: 5890855423 Enrollment ID: I20081126000532 |
| Provider Name | Monika Rejnin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619126190 PECOS PAC ID: 4284796160 Enrollment ID: I20081231000371 |
| Provider Name | Susan G Goodson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922109891 PECOS PAC ID: 7719040351 Enrollment ID: I20090108000482 |
| Provider Name | Marisa L Shaker |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659306314 PECOS PAC ID: 2062575525 Enrollment ID: I20090108000696 |
| Provider Name | Pia Dogbey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720260094 PECOS PAC ID: 1759445117 Enrollment ID: I20090129000348 |
| Provider Name | Danielle J Tarbell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518117886 PECOS PAC ID: 6103981659 Enrollment ID: I20090217000149 |
| Provider Name | Mark S Rosenberg |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851459390 PECOS PAC ID: 8325025380 Enrollment ID: I20090306000371 |
| Provider Name | Gwenn I Drapeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982859401 PECOS PAC ID: 7214094341 Enrollment ID: I20090317000430 |
| Provider Name | Leo R Otake |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1770761025 PECOS PAC ID: 1850448358 Enrollment ID: I20090421000426 |
| Provider Name | Melissa Battista |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629215553 PECOS PAC ID: 7214086792 Enrollment ID: I20090513000401 |
| Provider Name | Lisa E Shakun |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154561884 PECOS PAC ID: 1355491358 Enrollment ID: I20090612000547 |
| Provider Name | Jianhui Zhang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417170952 PECOS PAC ID: 1759431463 Enrollment ID: I20090617000667 |
| Provider Name | Nicole M Grilli |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710908694 PECOS PAC ID: 5092865741 Enrollment ID: I20090618000243 |
| Provider Name | Anthony J Cusano |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1205944089 PECOS PAC ID: 8527111749 Enrollment ID: I20090805000328 |
| Provider Name | Marc N Raad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316085665 PECOS PAC ID: 1355493776 Enrollment ID: I20090810000155 |
| Provider Name | Joycelyn D Maw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629166574 PECOS PAC ID: 9436203908 Enrollment ID: I20090818000473 |
| Provider Name | Arpana S Mohnani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154386373 PECOS PAC ID: 5799799078 Enrollment ID: I20090828000055 |
| Provider Name | Matthew C. Miller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225268626 PECOS PAC ID: 3476608100 Enrollment ID: I20090902000322 |
| Provider Name | David Klimowicz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356584718 PECOS PAC ID: 3577618701 Enrollment ID: I20090911000218 |
| Provider Name | Cesar F Fuentes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689861866 PECOS PAC ID: 4880733971 Enrollment ID: I20091203000019 |
| Provider Name | Chinyelu E Oraedu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932357548 PECOS PAC ID: 3971642000 Enrollment ID: I20091203000337 |
| Provider Name | Jeffrey D Martone |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1295760742 PECOS PAC ID: 8022157908 Enrollment ID: I20091207000198 |
| Provider Name | Fausto M Lanao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801844675 PECOS PAC ID: 5496895534 Enrollment ID: I20091221000398 |
| Provider Name | Kaitlin F Salkeld |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780918391 PECOS PAC ID: 1759421795 Enrollment ID: I20091222000669 |
| Provider Name | Leslie Coopersmith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801844147 PECOS PAC ID: 9931249794 Enrollment ID: I20091229000623 |
| Provider Name | Dana Chateauneuf |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518902600 PECOS PAC ID: 7719028919 Enrollment ID: I20100111000333 |
| Provider Name | Steven I Aronin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1164495875 PECOS PAC ID: 4789726290 Enrollment ID: I20100121000741 |
| Provider Name | J Michael Elser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982677894 PECOS PAC ID: 6901948355 Enrollment ID: I20100122000287 |
| Provider Name | David Knight |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841254539 PECOS PAC ID: 4082696489 Enrollment ID: I20100122000790 |
| Provider Name | Michael J Flanagan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902860166 PECOS PAC ID: 3870584626 Enrollment ID: I20100210000283 |
| Provider Name | Kenneth R Newton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194799700 PECOS PAC ID: 9830233980 Enrollment ID: I20100212000650 |
| Provider Name | Carla M Jacobson-kiel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235137316 PECOS PAC ID: 4486798162 Enrollment ID: I20100218000530 |
| Provider Name | Elizabeth Mirabile-levens |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437234622 PECOS PAC ID: 4284713728 Enrollment ID: I20100223000443 |
| Provider Name | Peter G Levinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881612851 PECOS PAC ID: 8628090149 Enrollment ID: I20100224000441 |
| Provider Name | Michael D Devanney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164756383 PECOS PAC ID: 4486798725 Enrollment ID: I20100224000481 |
| Provider Name | Stephen C Widman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346278512 PECOS PAC ID: 1759470503 Enrollment ID: I20100225000737 |
| Provider Name | David G Hill |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033226584 PECOS PAC ID: 3577642008 Enrollment ID: I20100316000302 |
| Provider Name | Richard S Silverman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679680110 PECOS PAC ID: 4284713710 Enrollment ID: I20100316000422 |
| Provider Name | Robert Mcdonald |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1023125549 PECOS PAC ID: 7012096548 Enrollment ID: I20100323000565 |
| Provider Name | Theresa M Caputo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740259886 PECOS PAC ID: 0143219188 Enrollment ID: I20100329001017 |
| Provider Name | Michael C Turk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407184138 PECOS PAC ID: 6204963655 Enrollment ID: I20100416000429 |
| Provider Name | Eric M Thompson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1942208202 PECOS PAC ID: 0244367241 Enrollment ID: I20100423000001 |
| Provider Name | Howard K Weiner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891787859 PECOS PAC ID: 9234105958 Enrollment ID: I20100506000449 |
| Provider Name | Kristine M Altwies |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255662946 PECOS PAC ID: 1759410186 Enrollment ID: I20100524000713 |
| Provider Name | Hana Hulinska |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1558590489 PECOS PAC ID: 2961531207 Enrollment ID: I20100526000876 |
| Provider Name | Andrew H Selinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114937141 PECOS PAC ID: 5294864245 Enrollment ID: I20100601000063 |
| Provider Name | Satish K Deshpande |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255399960 PECOS PAC ID: 2769424738 Enrollment ID: I20100629000281 |
| Provider Name | Sun King Wan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043290281 PECOS PAC ID: 6204880529 Enrollment ID: I20100813000102 |
| Provider Name | Kristin Giannini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881662443 PECOS PAC ID: 3375667140 Enrollment ID: I20100831000399 |
| Provider Name | Claudio P Milite |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1396761458 PECOS PAC ID: 3375667181 Enrollment ID: I20100831000943 |
| Provider Name | Angelito C Bacay |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1679506836 PECOS PAC ID: 1254336001 Enrollment ID: I20100831000965 |
| Provider Name | Venkateswara R Narla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1992790836 PECOS PAC ID: 2961527726 Enrollment ID: I20100916000720 |
| Provider Name | Gary Belt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699707422 PECOS PAC ID: 5890810550 Enrollment ID: I20100917000725 |
| Provider Name | Zhongqiu John Zhang |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1679725816 PECOS PAC ID: 4284750589 Enrollment ID: I20100923001099 |
| Provider Name | Paul Beauvais |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487731998 PECOS PAC ID: 8123140803 Enrollment ID: I20101014000939 |
| Provider Name | David W Sink |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114916798 PECOS PAC ID: 8022191188 Enrollment ID: I20101022000677 |
| Provider Name | Srinath Kadimi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730144734 PECOS PAC ID: 9931394715 Enrollment ID: I20101108000403 |
| Provider Name | Parveen Khanna |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881689727 PECOS PAC ID: 1355430687 Enrollment ID: I20101110001048 |
| Provider Name | Kimberly L Hayes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467448878 PECOS PAC ID: 2264627264 Enrollment ID: I20101117000077 |
| Provider Name | Candice T Pych |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871563098 PECOS PAC ID: 8426244344 Enrollment ID: I20101118000026 |
| Provider Name | Michael Damon Savarese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538170493 PECOS PAC ID: 1254239676 Enrollment ID: I20101215000006 |
| Provider Name | Akua a Sam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568454635 PECOS PAC ID: 3577751395 Enrollment ID: I20101221000627 |
| Provider Name | Linda T Mathew |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154395002 PECOS PAC ID: 5597953026 Enrollment ID: I20101227000731 |
| Provider Name | Farah L Choudhry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821061664 PECOS PAC ID: 7810185352 Enrollment ID: I20101227000792 |
| Provider Name | Michael Mayer Krinsky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508898339 PECOS PAC ID: 0749245553 Enrollment ID: I20110105001057 |
| Provider Name | Carine Jean |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982685889 PECOS PAC ID: 9931398583 Enrollment ID: I20110112000803 |
| Provider Name | Janet Lynne Vodra |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104834365 PECOS PAC ID: 4082893136 Enrollment ID: I20110121000733 |
| Provider Name | Jeffrey Howard Katz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780651745 PECOS PAC ID: 6305025073 Enrollment ID: I20110127000028 |
| Provider Name | Marlie D Schmidt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235449638 PECOS PAC ID: 8628258399 Enrollment ID: I20110212000032 |
| Provider Name | Lori Sobel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780660134 PECOS PAC ID: 9335321876 Enrollment ID: I20110304000632 |
| Provider Name | Danny Mancini |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376862532 PECOS PAC ID: 7517995970 Enrollment ID: I20110316000290 |
| Provider Name | Hector R Pun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447304944 PECOS PAC ID: 9537340625 Enrollment ID: I20110326000055 |
| Provider Name | Abigail M Hidalgo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447566195 PECOS PAC ID: 3577747062 Enrollment ID: I20110407000286 |
| Provider Name | Alan H Lozano |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275843633 PECOS PAC ID: 0941484299 Enrollment ID: I20110411000482 |
| Provider Name | Emily Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144386541 PECOS PAC ID: 4789724386 Enrollment ID: I20110418000728 |
| Provider Name | William Johns |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598773160 PECOS PAC ID: 4789869223 Enrollment ID: I20110427000782 |
| Provider Name | Victor E Ylagan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265464945 PECOS PAC ID: 4789861527 Enrollment ID: I20110606000015 |
| Provider Name | Jennifer M Trzaski-malash |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154503407 PECOS PAC ID: 9931386463 Enrollment ID: I20110608000817 |
| Provider Name | Carlo C Mccalla |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467679845 PECOS PAC ID: 5597859173 Enrollment ID: I20110616000083 |
| Provider Name | Diana Wagner |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1790893022 PECOS PAC ID: 7719910488 Enrollment ID: I20110906000269 |
| Provider Name | Leslie I Wolkoff |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518933845 PECOS PAC ID: 5698841930 Enrollment ID: I20110923000190 |
| Provider Name | Amy Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750617817 PECOS PAC ID: 5698946556 Enrollment ID: I20110926000487 |
| Provider Name | Gordon L Brodie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114995016 PECOS PAC ID: 8527230663 Enrollment ID: I20111021000546 |
| Provider Name | Crystal Rose |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356621478 PECOS PAC ID: 2163695586 Enrollment ID: I20111101000117 |
| Provider Name | Angela M Gaither |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083895825 PECOS PAC ID: 0749453041 Enrollment ID: I20111102000286 |
| Provider Name | Terry M Poppiti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467427948 PECOS PAC ID: 1153344833 Enrollment ID: I20111114000634 |
| Provider Name | Laura V Lucarelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386934578 PECOS PAC ID: 2860666203 Enrollment ID: I20111121000189 |
| Provider Name | Audrey M Lastra |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104105600 PECOS PAC ID: 4082888334 Enrollment ID: I20111122000660 |
| Provider Name | Heather M Nisbeth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912952243 PECOS PAC ID: 3072780956 Enrollment ID: I20120117000608 |
| Provider Name | Taisha Z Santiago |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962770131 PECOS PAC ID: 2860669751 Enrollment ID: I20120117000746 |
| Provider Name | Elise M Romanik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790730034 PECOS PAC ID: 9739356668 Enrollment ID: I20120118000349 |
| Provider Name | Saqib Naseer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962482109 PECOS PAC ID: 0941254262 Enrollment ID: I20120204000011 |
| Provider Name | David J Delucia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285788786 PECOS PAC ID: 0446431530 Enrollment ID: I20120220000330 |
| Provider Name | Catrina R Shubert |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578834875 PECOS PAC ID: 7719145234 Enrollment ID: I20120229000627 |
| Provider Name | Anna Camacho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558632257 PECOS PAC ID: 0446419105 Enrollment ID: I20120315000581 |
| Provider Name | Rachana Kanaujia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043441439 PECOS PAC ID: 9032373808 Enrollment ID: I20120606000489 |
| Provider Name | Eric a Camyre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831326461 PECOS PAC ID: 0244494045 Enrollment ID: I20120607000013 |
| Provider Name | Sreelakshmi L Reddivari |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093075038 PECOS PAC ID: 1456515675 Enrollment ID: I20120619000245 |
| Provider Name | Paul Fiore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669601811 PECOS PAC ID: 7719142884 Enrollment ID: I20120625000117 |
| Provider Name | Julia Zefirova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346472933 PECOS PAC ID: 0840455424 Enrollment ID: I20120705000164 |
| Provider Name | Nayyara Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275844987 PECOS PAC ID: 6103082581 Enrollment ID: I20120731000005 |
| Provider Name | Nick Ramandi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124219050 PECOS PAC ID: 2062668163 Enrollment ID: I20120806000343 |
| Provider Name | Andrea M Lagasse |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124383112 PECOS PAC ID: 4981850815 Enrollment ID: I20120809000214 |
| Provider Name | Charlotte Ward |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881956696 PECOS PAC ID: 5991953119 Enrollment ID: I20120913000295 |
| Provider Name | Marvelle L Lindo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639427735 PECOS PAC ID: 8426206020 Enrollment ID: I20120924000013 |
| Provider Name | Antonie Auguste |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1508063165 PECOS PAC ID: 0042469843 Enrollment ID: I20121011000790 |
| Provider Name | Alexandr Tarasyuk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427337385 PECOS PAC ID: 2567633209 Enrollment ID: I20121022000063 |
| Provider Name | James R Doran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942249610 PECOS PAC ID: 5698701548 Enrollment ID: I20121113000430 |
| Provider Name | Matthew Dolan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770834657 PECOS PAC ID: 7810148848 Enrollment ID: I20121121000141 |
| Provider Name | Edmond Beqiri |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346503612 PECOS PAC ID: 4284887886 Enrollment ID: I20130110000080 |
| Provider Name | Joseph P Kocot |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720339021 PECOS PAC ID: 4688827157 Enrollment ID: I20130111000260 |
| Provider Name | Jacquelyn L Browne |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457585267 PECOS PAC ID: 8325211519 Enrollment ID: I20130411000042 |
| Provider Name | Amina Asrar Ahmed |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174685556 PECOS PAC ID: 8628220548 Enrollment ID: I20130502000368 |
| Provider Name | Amy H Musco |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831409721 PECOS PAC ID: 4981885597 Enrollment ID: I20130523000256 |
| Provider Name | Sharon Tokarz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982958492 PECOS PAC ID: 4880832591 Enrollment ID: I20130607000086 |
| Provider Name | Ruchi Sharma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902240039 PECOS PAC ID: 4385883818 Enrollment ID: I20130613000447 |
| Provider Name | Diane Prado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477894772 PECOS PAC ID: 7416196399 Enrollment ID: I20130626000036 |
| Provider Name | Shweta Upadhyay |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1164782835 PECOS PAC ID: 5193966695 Enrollment ID: I20130725000710 |
| Provider Name | Christopher J. Mozdzanowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083866784 PECOS PAC ID: 7113181603 Enrollment ID: I20130731000781 |
| Provider Name | Lisa R Talati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235441890 PECOS PAC ID: 8527200443 Enrollment ID: I20130806000296 |
| Provider Name | Michael L Harris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730525593 PECOS PAC ID: 9739321233 Enrollment ID: I20130813000575 |
| Provider Name | Shihab Masrur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861623431 PECOS PAC ID: 4082856190 Enrollment ID: I20130819000793 |
| Provider Name | Brian Koo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346435930 PECOS PAC ID: 3476625344 Enrollment ID: I20130909000069 |
| Provider Name | Rizwan Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649403601 PECOS PAC ID: 7517101447 Enrollment ID: I20130916000685 |
| Provider Name | Yuliya V Riat |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1326274960 PECOS PAC ID: 8729222476 Enrollment ID: I20130918000639 |
| Provider Name | Angela Lea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467762781 PECOS PAC ID: 6608000856 Enrollment ID: I20131002000228 |
| Provider Name | Kalpesh a Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366785800 PECOS PAC ID: 7113151242 Enrollment ID: I20131003000417 |
| Provider Name | Eileen a Knox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831523638 PECOS PAC ID: 6305071531 Enrollment ID: I20131024001016 |
| Provider Name | Richard Ahrens |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417389735 PECOS PAC ID: 5698900553 Enrollment ID: I20131030001220 |
| Provider Name | Amy Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245664770 PECOS PAC ID: 9537394192 Enrollment ID: I20131107000153 |
| Provider Name | Steven R Pirola |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124065750 PECOS PAC ID: 0244361814 Enrollment ID: I20140214001296 |
| Provider Name | Mary C D Amico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710312533 PECOS PAC ID: 4981836905 Enrollment ID: I20140407000163 |
| Provider Name | Audrey E Douglas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659383404 PECOS PAC ID: 2163654948 Enrollment ID: I20140409001275 |
| Provider Name | Katherine a Dawber |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831234418 PECOS PAC ID: 3577796887 Enrollment ID: I20140512000499 |
| Provider Name | Anupma Saini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952570764 PECOS PAC ID: 5890810238 Enrollment ID: I20140516001341 |
| Provider Name | Renee M Brockett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639133077 PECOS PAC ID: 0840413407 Enrollment ID: I20140529000288 |
| Provider Name | Danise M Schiliro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619143252 PECOS PAC ID: 0941443675 Enrollment ID: I20140610000864 |
| Provider Name | Therese-ann Deal |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649484916 PECOS PAC ID: 5395969497 Enrollment ID: I20140611000856 |
| Provider Name | Emese Gal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265727432 PECOS PAC ID: 9638393416 Enrollment ID: I20140618000125 |
| Provider Name | Christina Koskinas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669480604 PECOS PAC ID: 2062636772 Enrollment ID: I20140620000223 |
| Provider Name | Crystal Hope |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053756288 PECOS PAC ID: 3274775499 Enrollment ID: I20140716000277 |
| Provider Name | Jennifer Chapman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679618318 PECOS PAC ID: 1153547195 Enrollment ID: I20140728000926 |
| Provider Name | Kimberly a Bottone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922391101 PECOS PAC ID: 4981821881 Enrollment ID: I20140818001250 |
| Provider Name | Erik J Carlson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992971808 PECOS PAC ID: 2567680705 Enrollment ID: I20140829000334 |
| Provider Name | Angela Marie Craft |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528363504 PECOS PAC ID: 0840418026 Enrollment ID: I20140829001496 |
| Provider Name | Cara E Pittari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548493273 PECOS PAC ID: 9537388228 Enrollment ID: I20140911000108 |
| Provider Name | Douglas C Klotzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184031171 PECOS PAC ID: 1153540505 Enrollment ID: I20140916002847 |
| Provider Name | Michael J Tanguay |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831590454 PECOS PAC ID: 7810119427 Enrollment ID: I20141117000223 |
| Provider Name | Nichole Kycia |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487061669 PECOS PAC ID: 1456673748 Enrollment ID: I20141121001751 |
| Provider Name | Wayne Rockhill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497188163 PECOS PAC ID: 8325360944 Enrollment ID: I20141209001482 |
| Provider Name | Jessica L Jean |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184012742 PECOS PAC ID: 8527384197 Enrollment ID: I20150226001513 |
| Provider Name | Andrea H Lynch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053702845 PECOS PAC ID: 4385961739 Enrollment ID: I20150323001963 |
| Provider Name | Kayla R Koza |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639560626 PECOS PAC ID: 3678890993 Enrollment ID: I20150326000506 |
| Provider Name | Stephanie Gunnoud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245636877 PECOS PAC ID: 8325365596 Enrollment ID: I20150327000283 |
| Provider Name | Nicole a Wizeman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134511595 PECOS PAC ID: 4688993157 Enrollment ID: I20150505001133 |
| Provider Name | Catherine Louise Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629462940 PECOS PAC ID: 0345560009 Enrollment ID: I20150520000527 |
| Provider Name | Roopkiranjot K Kahlon |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1003123548 PECOS PAC ID: 9335371434 Enrollment ID: I20150615001709 |
| Provider Name | Gopal C Sarker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316929607 PECOS PAC ID: 1850340456 Enrollment ID: I20150616002535 |
| Provider Name | Karolina Majk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487051777 PECOS PAC ID: 4183937444 Enrollment ID: I20150716001294 |
| Provider Name | Kaitlynn M Jones |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619392370 PECOS PAC ID: 9739492935 Enrollment ID: I20150716002646 |
| Provider Name | Pamela L Frappier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093195182 PECOS PAC ID: 6608181284 Enrollment ID: I20150811004565 |
| Provider Name | Kevin Reddington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447639208 PECOS PAC ID: 6204141435 Enrollment ID: I20150818004534 |
| Provider Name | Juan Diego Holguin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164650370 PECOS PAC ID: 5890001614 Enrollment ID: I20150825002911 |
| Provider Name | Liran Blum |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306007455 PECOS PAC ID: 7810057676 Enrollment ID: I20150914001225 |
| Provider Name | Jaime J Antunes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164805768 PECOS PAC ID: 0143537423 Enrollment ID: I20150918001427 |
| Provider Name | Kanwardeep Arora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508026428 PECOS PAC ID: 4486728516 Enrollment ID: I20151026000616 |
| Provider Name | Jameel C Uddeen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1669767059 PECOS PAC ID: 1456662261 Enrollment ID: I20151104002736 |
| Provider Name | Shawn Healy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568832582 PECOS PAC ID: 8123328218 Enrollment ID: I20151120002076 |
| Provider Name | Tricia E Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962714022 PECOS PAC ID: 0648597757 Enrollment ID: I20151123002290 |
| Provider Name | Kathleen Renee Fuschi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366818254 PECOS PAC ID: 3577863190 Enrollment ID: I20151203000112 |
| Provider Name | Katherine Kedzierski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548571110 PECOS PAC ID: 6204137672 Enrollment ID: I20151209002227 |
| Provider Name | Audrie L Karraker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730290743 PECOS PAC ID: 3971805631 Enrollment ID: I20160112002352 |
| Provider Name | Kristin Zaksewicz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720457831 PECOS PAC ID: 9335442631 Enrollment ID: I20160120001765 |
| Provider Name | Kristi-lee Cavallo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518303890 PECOS PAC ID: 3476856626 Enrollment ID: I20160121000772 |
| Provider Name | Mason P Dunn-mcdonagh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356716302 PECOS PAC ID: 2567766322 Enrollment ID: I20160215002449 |
| Provider Name | Nadine S Caron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487027678 PECOS PAC ID: 4082919097 Enrollment ID: I20160229000853 |
| Provider Name | Kirlene K Lindsay-henry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598121246 PECOS PAC ID: 2264739135 Enrollment ID: I20160322000404 |
| Provider Name | Meghan E Malentacchi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235391749 PECOS PAC ID: 2668779331 Enrollment ID: I20160323001243 |
| Provider Name | Tasha M Hamm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831349588 PECOS PAC ID: 9234436494 Enrollment ID: I20160404000012 |
| Provider Name | Hasmukh L Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659792588 PECOS PAC ID: 3577877059 Enrollment ID: I20160404001255 |
| Provider Name | Rebecca Demusis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063883627 PECOS PAC ID: 2264731439 Enrollment ID: I20160422001445 |
| Provider Name | Roshani Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265853154 PECOS PAC ID: 9830407071 Enrollment ID: I20160505000467 |
| Provider Name | Atsuko Yamahiro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730524653 PECOS PAC ID: 1557681541 Enrollment ID: I20160518001956 |
| Provider Name | Vanessa Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063885531 PECOS PAC ID: 5991006470 Enrollment ID: I20160523001726 |
| Provider Name | Kamraan Madhani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437491057 PECOS PAC ID: 8022312396 Enrollment ID: I20160526001945 |
| Provider Name | Riddhi Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710316385 PECOS PAC ID: 9234422510 Enrollment ID: I20160725000936 |
| Provider Name | Suleyman Felek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225478803 PECOS PAC ID: 3072806231 Enrollment ID: I20160726000526 |
| Provider Name | Katelyn M Zachau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932543592 PECOS PAC ID: 3476879958 Enrollment ID: I20160826000357 |
| Provider Name | Karyn J Hansen |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1700020062 PECOS PAC ID: 5698061117 Enrollment ID: I20160909001405 |
| Provider Name | Saloua Mabkhouti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457805475 PECOS PAC ID: 7012203409 Enrollment ID: I20160912000896 |
| Provider Name | Alyssa M Olsen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770933541 PECOS PAC ID: 6002102126 Enrollment ID: I20160915000852 |
| Provider Name | Ryan Artigliere |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649622903 PECOS PAC ID: 9931496767 Enrollment ID: I20160922001159 |
| Provider Name | Carly M Muniz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225484314 PECOS PAC ID: 3870880164 Enrollment ID: I20160930000499 |
| Provider Name | Mauricio Silva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609162197 PECOS PAC ID: 9032335120 Enrollment ID: I20161010000555 |
| Provider Name | Marinela Y Ingilizova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114297157 PECOS PAC ID: 8426283078 Enrollment ID: I20161024000715 |
| Provider Name | Rebecca F Dreyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881803757 PECOS PAC ID: 6002194933 Enrollment ID: I20161028000217 |
| Provider Name | Hannah M Urgo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891143459 PECOS PAC ID: 0941588354 Enrollment ID: I20161104001100 |
| Provider Name | Andrea Dufour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679021273 PECOS PAC ID: 2062791007 Enrollment ID: I20161116000693 |
| Provider Name | Michele Cooper |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174853634 PECOS PAC ID: 7719150549 Enrollment ID: I20161116001675 |
| Provider Name | Angel E Castro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477901718 PECOS PAC ID: 6901186253 Enrollment ID: I20161205000129 |
| Provider Name | Laura Dove |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023214582 PECOS PAC ID: 5092806208 Enrollment ID: I20161213001577 |
| Provider Name | Rushickah Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093267981 PECOS PAC ID: 0840572079 Enrollment ID: I20170124002313 |
| Provider Name | Denisse Burgos-jimenez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013455351 PECOS PAC ID: 6002190774 Enrollment ID: I20170223001817 |
| Provider Name | Faraz M Sabir |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063951200 PECOS PAC ID: 6103100144 Enrollment ID: I20170310001688 |
| Provider Name | Peter S Hanna |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003362351 PECOS PAC ID: 7719267434 Enrollment ID: I20170323000539 |
| Provider Name | Zacharia K El-samin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033655378 PECOS PAC ID: 8022393446 Enrollment ID: I20170328001105 |
| Provider Name | Rachael E Staub |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518361856 PECOS PAC ID: 7719280551 Enrollment ID: I20170505000193 |
| Provider Name | Arslan Johnghar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568755700 PECOS PAC ID: 8123248135 Enrollment ID: I20170707000290 |
| Provider Name | Benjamin Ristau |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1588891196 PECOS PAC ID: 0345553350 Enrollment ID: I20170712003134 |
| Provider Name | Raphael Shaw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902218597 PECOS PAC ID: 6800168436 Enrollment ID: I20170817000201 |
| Provider Name | Kai H Hammerich |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1639308810 PECOS PAC ID: 4183996549 Enrollment ID: I20170818001942 |
| Provider Name | Saad a Qadwai |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578962601 PECOS PAC ID: 1658643572 Enrollment ID: I20170828000397 |
| Provider Name | Felicia F Mingrone |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215458740 PECOS PAC ID: 7416220538 Enrollment ID: I20170911003076 |
| Provider Name | Sarah M Montavon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629213574 PECOS PAC ID: 5395019178 Enrollment ID: I20170918001072 |
| Provider Name | David W Yaffee |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1306010517 PECOS PAC ID: 9537433925 Enrollment ID: I20170925000226 |
| Provider Name | Katherine B Mullis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619493400 PECOS PAC ID: 9032485941 Enrollment ID: I20171020001155 |
| Provider Name | Danielle M Kirei |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033638366 PECOS PAC ID: 3173899549 Enrollment ID: I20171031000125 |
| Provider Name | Danielle Nardone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386189645 PECOS PAC ID: 0840556957 Enrollment ID: I20171106002294 |
| Provider Name | Julia I. D. Vitali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508276346 PECOS PAC ID: 1850617341 Enrollment ID: I20171109002359 |
| Provider Name | Aleksandra Belonick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740706027 PECOS PAC ID: 9537426895 Enrollment ID: I20171122001401 |
| Provider Name | Heather Cerasale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407367113 PECOS PAC ID: 5496013237 Enrollment ID: I20171227001703 |
| Provider Name | Kathryn Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932621521 PECOS PAC ID: 8426316027 Enrollment ID: I20180102001580 |
| Provider Name | Kelli a Harper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245641174 PECOS PAC ID: 5597081075 Enrollment ID: I20180110003282 |
| Provider Name | Shea M Kozak |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740794106 PECOS PAC ID: 6800155672 Enrollment ID: I20180124002057 |
| Provider Name | Tracy Follert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245741701 PECOS PAC ID: 9436419629 Enrollment ID: I20180208000791 |
| Provider Name | Regina M. Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831638360 PECOS PAC ID: 0446511919 Enrollment ID: I20180223001772 |
| Provider Name | Joanna P Chaurette |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457748816 PECOS PAC ID: 9931460474 Enrollment ID: I20180226002405 |
| Provider Name | Quratul Ane Lodhi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841656113 PECOS PAC ID: 3779846472 Enrollment ID: I20180411000767 |
| Provider Name | Alissa B Pascucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144764507 PECOS PAC ID: 9931462249 Enrollment ID: I20180420000152 |
| Provider Name | Jesmi K Stanislavose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861915282 PECOS PAC ID: 4284998964 Enrollment ID: I20180504000163 |
| Provider Name | Desiree Lynn Lavery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265929533 PECOS PAC ID: 2264796739 Enrollment ID: I20180509000957 |
| Provider Name | Violet Pastorkova-jaouen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679077754 PECOS PAC ID: 7012271307 Enrollment ID: I20180515000687 |
| Provider Name | Laura M Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730687666 PECOS PAC ID: 4880958081 Enrollment ID: I20180515001600 |
| Provider Name | Mamta Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891031522 PECOS PAC ID: 0244542066 Enrollment ID: I20180522002127 |
| Provider Name | Nishanth Reddy Pundru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205241288 PECOS PAC ID: 5395022644 Enrollment ID: I20180529002018 |
| Provider Name | Stacy B Beaupre |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528388709 PECOS PAC ID: 2466636949 Enrollment ID: I20180531002484 |
| Provider Name | Sarah Yiznitsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285164111 PECOS PAC ID: 6901161413 Enrollment ID: I20180605001172 |
| Provider Name | Ronak Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700272515 PECOS PAC ID: 2860757176 Enrollment ID: I20180606003451 |
| Provider Name | Prabhdeep Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790162790 PECOS PAC ID: 4486909116 Enrollment ID: I20180620001163 |
| Provider Name | Allison Dziemaszkiewicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306148861 PECOS PAC ID: 2062767627 Enrollment ID: I20180622000368 |
| Provider Name | Caitlin Paige Stavens-meucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023538980 PECOS PAC ID: 3274809645 Enrollment ID: I20180627002377 |
| Provider Name | Kelsey Elizabeth Mckee |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346742467 PECOS PAC ID: 5991051195 Enrollment ID: I20180702000033 |
| Provider Name | Ivy Dwomoh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952786659 PECOS PAC ID: 0749536894 Enrollment ID: I20180703002763 |
| Provider Name | Allison L Waggoner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497149397 PECOS PAC ID: 4688975543 Enrollment ID: I20180719000612 |
| Provider Name | Iyanna Atwell Liles |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588083554 PECOS PAC ID: 4385964428 Enrollment ID: I20180809000146 |
| Provider Name | Armenia Mordan Vasquez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891179735 PECOS PAC ID: 3678821378 Enrollment ID: I20180810002353 |
| Provider Name | Essam Nakhla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487910410 PECOS PAC ID: 0547519506 Enrollment ID: I20180823003238 |
| Provider Name | Elizabeth a Lawton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881172500 PECOS PAC ID: 1759632508 Enrollment ID: I20180918003666 |
| Provider Name | Alexis Daloisio |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871071902 PECOS PAC ID: 0345591707 Enrollment ID: I20180924002348 |
| Provider Name | Muhammad S Amjad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508247305 PECOS PAC ID: 7315256062 Enrollment ID: I20181023002800 |
| Provider Name | Cara Lousie Thomson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386974434 PECOS PAC ID: 9537412135 Enrollment ID: I20181029002840 |
| Provider Name | Kerry Petrello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578041430 PECOS PAC ID: 4880947399 Enrollment ID: I20181031001040 |
| Provider Name | Thomas R Rozea |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962988592 PECOS PAC ID: 5496009219 Enrollment ID: I20181114002399 |
| Provider Name | Jennifer Ann Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376669648 PECOS PAC ID: 0749534410 Enrollment ID: I20181115000964 |
| Provider Name | Eyone Jones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013279199 PECOS PAC ID: 3678819794 Enrollment ID: I20190110002541 |
| Provider Name | Abike Becroft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588146351 PECOS PAC ID: 0446598759 Enrollment ID: I20190212002341 |
| Provider Name | Deon Johnson-allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124592274 PECOS PAC ID: 9638418197 Enrollment ID: I20190227001366 |
| Provider Name | Lori a Washenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528538196 PECOS PAC ID: 4587903984 Enrollment ID: I20190301001054 |
| Provider Name | Mathias I Aihiokhai |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003270497 PECOS PAC ID: 4284929670 Enrollment ID: I20190419000174 |
| Provider Name | Khaled Carvan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811350499 PECOS PAC ID: 3971893785 Enrollment ID: I20190524001300 |
| Provider Name | Sheila Jane Tan Zanoria |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1508182965 PECOS PAC ID: 2668783564 Enrollment ID: I20190617002252 |
| Provider Name | Medhat Ghaly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407218761 PECOS PAC ID: 9931494184 Enrollment ID: I20190620002567 |
| Provider Name | Joseph De Beauvoir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659733624 PECOS PAC ID: 6800186248 Enrollment ID: I20190715000941 |
| Provider Name | Cory R. Degiacomo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649712894 PECOS PAC ID: 8729314778 Enrollment ID: I20190729001650 |
| Provider Name | Michael Aaron Mayo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922565985 PECOS PAC ID: 8123354982 Enrollment ID: I20190731002962 |
| Provider Name | Hannah C Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346892775 PECOS PAC ID: 7911235056 Enrollment ID: I20190827002351 |
| Provider Name | Stephanie L. White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942682422 PECOS PAC ID: 4789913682 Enrollment ID: I20190830002411 |
| Provider Name | Erin Greenberg Hartnett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508129081 PECOS PAC ID: 4486950938 Enrollment ID: I20190910002194 |
| Provider Name | Huma Khan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750849253 PECOS PAC ID: 2769712447 Enrollment ID: I20190923002451 |
| Provider Name | Kelly Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528521408 PECOS PAC ID: 1658601893 Enrollment ID: I20191001001493 |
| Provider Name | Betsy Larose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851648398 PECOS PAC ID: 7911239199 Enrollment ID: I20191022001390 |
| Provider Name | Nicole Marie Ferretti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730435355 PECOS PAC ID: 1557693637 Enrollment ID: I20191022001933 |
| Provider Name | Chiquana Allman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417501115 PECOS PAC ID: 0042542730 Enrollment ID: I20191030000860 |
| Provider Name | Benjamin Iapaluccio |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972158228 PECOS PAC ID: 8628300357 Enrollment ID: I20191030002555 |
| Provider Name | Jaime Verastegui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639520323 PECOS PAC ID: 7315379500 Enrollment ID: I20191108000677 |
| Provider Name | Anna Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831212471 PECOS PAC ID: 2567890114 Enrollment ID: I20200316000345 |
| Provider Name | Maisha Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063966273 PECOS PAC ID: 8224466412 Enrollment ID: I20200323000930 |
| Provider Name | Rachel Ellen London |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447884978 PECOS PAC ID: 5294163374 Enrollment ID: I20200324001910 |
| Provider Name | Taylor Alexandra Babin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871125401 PECOS PAC ID: 7315377132 Enrollment ID: I20200420000315 |
| Provider Name | Susan Antoinette Pappas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720616246 PECOS PAC ID: 3274964333 Enrollment ID: I20200506000880 |
| Provider Name | Rinku Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588289128 PECOS PAC ID: 0840614079 Enrollment ID: I20200721003856 |
| Provider Name | Joanna D Brown |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912529660 PECOS PAC ID: 8921423591 Enrollment ID: I20200730001869 |
| Provider Name | Fahmida H Mcgann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154716678 PECOS PAC ID: 3678886116 Enrollment ID: I20200804002972 |
| Provider Name | Katelyn Iva Norman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194259408 PECOS PAC ID: 6507282647 Enrollment ID: I20200819002397 |
| Provider Name | Tijana Samardzic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851910871 PECOS PAC ID: 6204253925 Enrollment ID: I20200826002550 |
| Provider Name | Samantha Ann Pacileo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427604594 PECOS PAC ID: 2365869740 Enrollment ID: I20200831001846 |
| Provider Name | Amanda Catherine Ehresman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689297418 PECOS PAC ID: 1759709751 Enrollment ID: I20200908001544 |
| Provider Name | Youlan Tang-kipers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154789840 PECOS PAC ID: 6901224229 Enrollment ID: I20200917001755 |
| Provider Name | Ann Skariya |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902338601 PECOS PAC ID: 7911278940 Enrollment ID: I20200929002599 |
| Provider Name | Nathan Lemay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205361532 PECOS PAC ID: 8123448370 Enrollment ID: I20201009000378 |
| Provider Name | Jordan Steven Totaro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780292615 PECOS PAC ID: 9234549627 Enrollment ID: I20201114000117 |
| Provider Name | Christine Zarrella Cipriani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306456116 PECOS PAC ID: 2365853777 Enrollment ID: I20201116000972 |
| Provider Name | Jennifer Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396362125 PECOS PAC ID: 2466863550 Enrollment ID: I20201120001318 |
| Provider Name | Kathleen Wilcox |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467075077 PECOS PAC ID: 1355752270 Enrollment ID: I20201127000007 |
| Provider Name | Raafat a Gorgy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700137734 PECOS PAC ID: 9638494743 Enrollment ID: I20201219000075 |
| Provider Name | Christie Czarnecki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255993762 PECOS PAC ID: 2567875172 Enrollment ID: I20201228001808 |
| Provider Name | Megan Emily Martocchio |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962031336 PECOS PAC ID: 7012321557 Enrollment ID: I20210125002598 |
| Provider Name | Nicole M Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710364211 PECOS PAC ID: 4688981160 Enrollment ID: I20210129000128 |
| Provider Name | Ashraf M Oloufa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285689901 PECOS PAC ID: 4183606106 Enrollment ID: I20210301002305 |
| Provider Name | Sara E Tse |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558573758 PECOS PAC ID: 2567758154 Enrollment ID: I20210310002018 |
| Provider Name | Mohammad Usmani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710420401 PECOS PAC ID: 6800136284 Enrollment ID: I20210421002348 |
| Provider Name | Christina J Schwindt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699228353 PECOS PAC ID: 2365724515 Enrollment ID: I20210504002649 |
| Provider Name | Neil Bidon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225644966 PECOS PAC ID: 0840609772 Enrollment ID: I20210506000065 |
| Provider Name | Bryan Fix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982213997 PECOS PAC ID: 0749689503 Enrollment ID: I20210527000599 |
| Provider Name | Andrea Lynn Delaire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669082830 PECOS PAC ID: 6901206226 Enrollment ID: I20210608002444 |
| Provider Name | Matthew Briscoe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285212639 PECOS PAC ID: 6709288046 Enrollment ID: I20210709000999 |
| Provider Name | Jennifer Michele Mchugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366037889 PECOS PAC ID: 7911309984 Enrollment ID: I20210713002987 |
| Provider Name | Jackson Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710480892 PECOS PAC ID: 3678976735 Enrollment ID: I20210727001951 |
| Provider Name | Gregory Michael Ricketts |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326459454 PECOS PAC ID: 4789087552 Enrollment ID: I20210730002443 |
| Provider Name | Nana Yaa N Chihombori-quao |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295269744 PECOS PAC ID: 3779853528 Enrollment ID: I20210802000845 |
| Provider Name | Daniel Tylee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194284109 PECOS PAC ID: 4082948682 Enrollment ID: I20210809002464 |
| Provider Name | James Joseph Mclarney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528507217 PECOS PAC ID: 7214211390 Enrollment ID: I20210812001386 |
| Provider Name | Anna Ziganshina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629431630 PECOS PAC ID: 6608166038 Enrollment ID: I20210819001865 |
| Provider Name | Bemen Habashi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487159877 PECOS PAC ID: 4688079031 Enrollment ID: I20210823002198 |
| Provider Name | Uchenna Okereke |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1437566205 PECOS PAC ID: 2062849813 Enrollment ID: I20210824003445 |
| Provider Name | Jackson Watson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124696653 PECOS PAC ID: 3678979572 Enrollment ID: I20210901000319 |
| Provider Name | Ashley Steinis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356015051 PECOS PAC ID: 0244636728 Enrollment ID: I20210908003489 |
| Provider Name | Kausar Khan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194490359 PECOS PAC ID: 8628474806 Enrollment ID: I20210914001616 |
| Provider Name | Amanda Calhoun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992360903 PECOS PAC ID: 2466780853 Enrollment ID: I20210920000161 |
| Provider Name | Elizabeth Pereira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083381966 PECOS PAC ID: 6709283435 Enrollment ID: I20210923001265 |
| Provider Name | Marie Sanzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366008963 PECOS PAC ID: 1254738818 Enrollment ID: I20210923002618 |
| Provider Name | Arit E Esu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225533649 PECOS PAC ID: 2365840014 Enrollment ID: I20211011000089 |
| Provider Name | Iwona Stachelek |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386306090 PECOS PAC ID: 5799173886 Enrollment ID: I20211021002475 |
| Provider Name | Stephanie Alexandra Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306411749 PECOS PAC ID: 0840688347 Enrollment ID: I20211103001065 |
| Provider Name | Alexander D Vendetto |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316609456 PECOS PAC ID: 6800285248 Enrollment ID: I20211105000948 |
| Provider Name | Anna Ziganshina |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1629431630 PECOS PAC ID: 6608166038 Enrollment ID: I20211108001956 |
| Provider Name | Sebina Bulic |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831326750 PECOS PAC ID: 9931407848 Enrollment ID: I20220106002541 |
| Provider Name | Steve M Cordina |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972777290 PECOS PAC ID: 6002084498 Enrollment ID: I20220107000346 |
| Provider Name | Leonard Dasilva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902873185 PECOS PAC ID: 9830096718 Enrollment ID: I20220107002160 |
| Provider Name | Preet Varade |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467780551 PECOS PAC ID: 3870801657 Enrollment ID: I20220107002364 |
| Provider Name | Alexander Zubkov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992721658 PECOS PAC ID: 0244260081 Enrollment ID: I20220110001789 |
| Provider Name | Michael Katsnelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013170067 PECOS PAC ID: 6406989177 Enrollment ID: I20220110001933 |
| Provider Name | Amirhossein Zangiabadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326294562 PECOS PAC ID: 8628233517 Enrollment ID: I20220111000120 |
| Provider Name | Nada Owees |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225533078 PECOS PAC ID: 6800131913 Enrollment ID: I20220115000003 |
| Provider Name | Mark Nathan Rubin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104055169 PECOS PAC ID: 9931394491 Enrollment ID: I20220120001104 |
| Provider Name | Christina Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689340747 PECOS PAC ID: 0648662841 Enrollment ID: I20220120001821 |
| Provider Name | Tracey Melissa Modeste |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871025973 PECOS PAC ID: 8820481179 Enrollment ID: I20220209000251 |
| Provider Name | Katherine Fontaine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013172311 PECOS PAC ID: 2163607227 Enrollment ID: I20220222001085 |
| Provider Name | Deanett Coran Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104571595 PECOS PAC ID: 5890180459 Enrollment ID: I20220317000061 |
| Provider Name | Jeremiah Peter Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700546421 PECOS PAC ID: 5799170239 Enrollment ID: I20220318000699 |
| Provider Name | Lauren Speringo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093215378 PECOS PAC ID: 0648665943 Enrollment ID: I20220324000213 |
| Provider Name | Katrina Carotenuti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649926528 PECOS PAC ID: 8527453687 Enrollment ID: I20220328001828 |
| Provider Name | Neelam Tailor |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1013371756 PECOS PAC ID: 4587098777 Enrollment ID: I20220609000474 |
| Provider Name | Mojtaba Mirzaei |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841753225 PECOS PAC ID: 5193050664 Enrollment ID: I20220615001498 |
| Provider Name | Ammar Huq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417418534 PECOS PAC ID: 9830376391 Enrollment ID: I20220629002895 |
| Provider Name | Humam Huq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306305156 PECOS PAC ID: 5799941324 Enrollment ID: I20220701000609 |
| Provider Name | Chelsey Ann Shaban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417696840 PECOS PAC ID: 4284014960 Enrollment ID: I20220712002649 |
| Provider Name | Momina Afrede |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750842951 PECOS PAC ID: 8325429426 Enrollment ID: I20220720003761 |
| Provider Name | Bilal Ghassan Jaradat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669032504 PECOS PAC ID: 9931581824 Enrollment ID: I20220809003632 |
| Provider Name | Christina E Lillywhite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295467181 PECOS PAC ID: 1850774738 Enrollment ID: I20220810003580 |
| Provider Name | Caroline Seeberg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902548688 PECOS PAC ID: 0941683072 Enrollment ID: I20220822003368 |
| Provider Name | Jennifer Lee Rollins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477292068 PECOS PAC ID: 1557745593 Enrollment ID: I20220825000903 |
| Provider Name | Ahmed Ewida |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720462021 PECOS PAC ID: 2264781764 Enrollment ID: I20220908002171 |
| Provider Name | Neslyne B Augustin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245729631 PECOS PAC ID: 4789080045 Enrollment ID: I20221005000578 |
| Provider Name | Douglas Valenta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851553879 PECOS PAC ID: 4688728181 Enrollment ID: I20221010001173 |
| Provider Name | Gabriella E Pignataro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831760040 PECOS PAC ID: 2860897592 Enrollment ID: I20221215001654 |
| Provider Name | Vinessa Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881214377 PECOS PAC ID: 0143643007 Enrollment ID: I20221219000638 |
| Provider Name | Netania Durogean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033834809 PECOS PAC ID: 2860862760 Enrollment ID: I20230111001130 |
| Provider Name | Christina Krzywicki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548634942 PECOS PAC ID: 3476925231 Enrollment ID: I20230206000593 |
| Provider Name | Dana Dwyer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376554493 PECOS PAC ID: 8921004227 Enrollment ID: I20230209002635 |
| Provider Name | Joanna Ewelina Majcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902510910 PECOS PAC ID: 3274905443 Enrollment ID: I20230216001208 |
| Provider Name | Esmeralda Christopher |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497429559 PECOS PAC ID: 7911370390 Enrollment ID: I20230306001772 |
| Provider Name | M. Lisa Attebery |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649385626 PECOS PAC ID: 2365492527 Enrollment ID: I20230317002187 |
| Provider Name | Davida Y Goltz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053725044 PECOS PAC ID: 8729324082 Enrollment ID: I20230321002754 |
| Provider Name | Vinodh Doss |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336348085 PECOS PAC ID: 5698930683 Enrollment ID: I20230321002916 |
| Provider Name | Mackenzie Phelps |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487254892 PECOS PAC ID: 2961876412 Enrollment ID: I20230323001300 |
| Provider Name | Sareem Wani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861621096 PECOS PAC ID: 7517123201 Enrollment ID: I20230324002126 |
| Provider Name | Chidi Okoroafor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932668886 PECOS PAC ID: 7810222866 Enrollment ID: I20230427001317 |
| Provider Name | Manu Dhawan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174146575 PECOS PAC ID: 6608231238 Enrollment ID: I20230503001575 |
| Provider Name | Alexis M Mcduff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629789409 PECOS PAC ID: 3173980828 Enrollment ID: I20230612001161 |
| Provider Name | Colin Burgess |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689106304 PECOS PAC ID: 0244574432 Enrollment ID: I20230612001439 |
| Provider Name | Yvan Tranquille |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134573827 PECOS PAC ID: 1355776022 Enrollment ID: I20230629002171 |
| Provider Name | Becky O'neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790930303 PECOS PAC ID: 8628218765 Enrollment ID: I20230712001112 |
| Provider Name | Andrea Little |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1356793806 PECOS PAC ID: 0840652889 Enrollment ID: I20230808003081 |
| Provider Name | Camillo Ferrari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588287999 PECOS PAC ID: 9133581077 Enrollment ID: I20230809003231 |
| Provider Name | Emily Rachel Cronin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689308165 PECOS PAC ID: 7618330390 Enrollment ID: I20230829000255 |
| Provider Name | Raquel Delgadillo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942984018 PECOS PAC ID: 1254795206 Enrollment ID: I20230911001441 |
| Provider Name | Dorcas Poni Eshun |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295088854 PECOS PAC ID: 1355596354 Enrollment ID: I20230918002619 |
| Provider Name | Hannah Goodale |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932885639 PECOS PAC ID: 1951755057 Enrollment ID: I20230922002645 |
| Provider Name | Michele Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306622444 PECOS PAC ID: 6305290370 Enrollment ID: I20230925001833 |
| Provider Name | Ana Quintana Villafuerte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144907882 PECOS PAC ID: 8628423886 Enrollment ID: I20231009003156 |
| Provider Name | Kaitlin Frances Holihan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548046824 PECOS PAC ID: 0840645891 Enrollment ID: I20231011000200 |
| Provider Name | Sun-joo Jang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659900595 PECOS PAC ID: 0941624134 Enrollment ID: I20231019002492 |
| Provider Name | Nadia Kousar |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1306002233 PECOS PAC ID: 1850518515 Enrollment ID: I20231102001182 |
| Provider Name | Jennifer Lee Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508643750 PECOS PAC ID: 7012364458 Enrollment ID: I20231107002686 |
| Provider Name | Ibrahim Mohsin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356962393 PECOS PAC ID: 4880041078 Enrollment ID: I20231109001435 |
| Provider Name | Sabina M Zawadzka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396109021 PECOS PAC ID: 8820382864 Enrollment ID: I20231115002030 |
| Provider Name | Sarah E Scolpini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417739665 PECOS PAC ID: 7517315070 Enrollment ID: I20231122002010 |
| Provider Name | Rabeea Nazir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023545217 PECOS PAC ID: 8628498904 Enrollment ID: I20231201001360 |
| Provider Name | Diana Zhong |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1376924365 PECOS PAC ID: 2163721861 Enrollment ID: I20231212002191 |
| Provider Name | Julia K Cornett |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1679884738 PECOS PAC ID: 3779779251 Enrollment ID: I20231220002779 |
| Provider Name | Kostas Papamarkakis |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1699160234 PECOS PAC ID: 4587977194 Enrollment ID: I20231227001726 |
| Provider Name | Varvara S Mironova |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114374303 PECOS PAC ID: 1052605797 Enrollment ID: I20240112001389 |
| Provider Name | Anne M Gaetano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679841126 PECOS PAC ID: 1850743915 Enrollment ID: I20240115000868 |
| Provider Name | Bethsaida Torres |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639455942 PECOS PAC ID: 9335591387 Enrollment ID: I20240116002049 |
| Provider Name | Paul Catella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982083663 PECOS PAC ID: 6709124811 Enrollment ID: I20240118003109 |
| Provider Name | Amy Jensen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043730443 PECOS PAC ID: 7113370008 Enrollment ID: I20240126002576 |
| Provider Name | Carrie Marie Scampolino |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114900065 PECOS PAC ID: 3870946775 Enrollment ID: I20240126002921 |
| Provider Name | Kaitlin Marcil |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457726234 PECOS PAC ID: 9739532656 Enrollment ID: I20240126003572 |
| Provider Name | Jason R Schwarz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245567452 PECOS PAC ID: 3870946791 Enrollment ID: I20240126003776 |
| Provider Name | Hugh Smolin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942282611 PECOS PAC ID: 9931552783 Enrollment ID: I20240128000129 |
| Provider Name | Samaria Erica Greene |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639325574 PECOS PAC ID: 0840643680 Enrollment ID: I20240129003083 |
| Provider Name | Joanne Margaret Seymour |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417930637 PECOS PAC ID: 2567815301 Enrollment ID: I20240129003130 |
| Provider Name | Ananias Gloria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043091408 PECOS PAC ID: 1254784879 Enrollment ID: I20240131001250 |
| Provider Name | Edward Vegliante |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235473000 PECOS PAC ID: 3870946312 Enrollment ID: I20240131002464 |
| Provider Name | Caitlin Seibert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588255111 PECOS PAC ID: 4981047479 Enrollment ID: I20240212004080 |
| Provider Name | Bruno Valentine Lozito |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356308514 PECOS PAC ID: 4082058912 Enrollment ID: I20240220001475 |
| Provider Name | Kelly Nicole Carter-maynard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659578649 PECOS PAC ID: 2365887841 Enrollment ID: I20240226000037 |
| Provider Name | Kara Ferraro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033972112 PECOS PAC ID: 7719322817 Enrollment ID: I20240228003361 |
| Provider Name | Michael John Portal |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265206056 PECOS PAC ID: 0143667287 Enrollment ID: I20240325001686 |
| Provider Name | Sarah Burgdorf |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801213780 PECOS PAC ID: 5193053346 Enrollment ID: I20240327003326 |
| Provider Name | Weijun Jin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861812083 PECOS PAC ID: 1557609310 Enrollment ID: I20240401002995 |
| Provider Name | Becky Elizabeth Tartaglia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275399016 PECOS PAC ID: 7810335585 Enrollment ID: I20240402000048 |
| Provider Name | Flordeliza Palazzolo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417919358 PECOS PAC ID: 6800234071 Enrollment ID: I20240406000244 |
| Provider Name | Jordan Y Amar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407340409 PECOS PAC ID: 2466832019 Enrollment ID: I20240409003457 |
| Provider Name | Alice Claire Baker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154810992 PECOS PAC ID: 7810231073 Enrollment ID: I20240418001274 |
| Provider Name | Rozah Arran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063125151 PECOS PAC ID: 1759722689 Enrollment ID: I20240509002428 |
| Provider Name | Allison Sadowski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396241923 PECOS PAC ID: 7214287796 Enrollment ID: I20240529001814 |
| Provider Name | Kimberly Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568203438 PECOS PAC ID: 4385187780 Enrollment ID: I20240613002052 |
| Provider Name | Parkash Stephanie Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659957611 PECOS PAC ID: 1658774377 Enrollment ID: I20240617002304 |
| Provider Name | Abdullah Ibish |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154783397 PECOS PAC ID: 0749610582 Enrollment ID: I20240621002070 |
| Provider Name | Michael J Granieri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730767229 PECOS PAC ID: 9335541101 Enrollment ID: I20240723004257 |
| Provider Name | Fady S Grace |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669679007 PECOS PAC ID: 4587750807 Enrollment ID: I20240903002251 |
| Provider Name | Maria Del Carmen Vega |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609447671 PECOS PAC ID: 7214477215 Enrollment ID: I20240905000655 |
| Provider Name | Kamara Mcleod |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407094584 PECOS PAC ID: 2961638036 Enrollment ID: I20240917001208 |
| Provider Name | Kathryn Addy Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598344954 PECOS PAC ID: 7315488632 Enrollment ID: I20240926000281 |
| Provider Name | Daniel Michel Bibawy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801461405 PECOS PAC ID: 6204368939 Enrollment ID: I20241018000961 |
| Provider Name | Omar Saeed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477059756 PECOS PAC ID: 7719234335 Enrollment ID: I20241023004251 |
| Provider Name | Georgios Mihalopulos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043796790 PECOS PAC ID: 8729511324 Enrollment ID: I20241104001129 |
| Provider Name | Megha Dasani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750917670 PECOS PAC ID: 6709310352 Enrollment ID: I20241105003686 |
| Provider Name | James J Aglio |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962992669 PECOS PAC ID: 5193061885 Enrollment ID: I20241108002163 |
| Provider Name | Iram Arslan Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407438294 PECOS PAC ID: 7012441181 Enrollment ID: I20241112001852 |
| Provider Name | Amanda Fernandes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205677945 PECOS PAC ID: 6103351358 Enrollment ID: I20241125001450 |
| Provider Name | Abhi Pandhi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730594011 PECOS PAC ID: 0840541512 Enrollment ID: I20241205002970 |
| Provider Name | Scarlett Kathryn Forbes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912104902 PECOS PAC ID: 5294262507 Enrollment ID: I20241227002124 |
| Provider Name | Lisa Scott |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922453471 PECOS PAC ID: 1951782341 Enrollment ID: I20250131002453 |
| Provider Name | Rabea Khedimi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891043519 PECOS PAC ID: 4880900778 Enrollment ID: I20250220001578 |
| Provider Name | Gina Ciambriello |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154128999 PECOS PAC ID: 0244753812 Enrollment ID: I20250325002096 |
| Provider Name | Lydia Loiselle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396531273 PECOS PAC ID: 1254859374 Enrollment ID: I20250513001425 |
| Provider Name | Jean Paula Yacelga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992501290 PECOS PAC ID: 4688192206 Enrollment ID: I20250519000251 |
| Provider Name | Eliza Gentzler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770042681 PECOS PAC ID: 9638407273 Enrollment ID: I20250520001501 |
| Provider Name | Jacob Kelner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942763339 PECOS PAC ID: 7214267327 Enrollment ID: I20250603001249 |
| Provider Name | Adam M Boise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124371299 PECOS PAC ID: 8820228760 Enrollment ID: I20250612001065 |
| Provider Name | Sarah St John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174312268 PECOS PAC ID: 9638687379 Enrollment ID: I20250804002130 |
| Provider Name | Tracy Marie Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659178424 PECOS PAC ID: 3173031515 Enrollment ID: I20250805004078 |
| Provider Name | William Leach |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1114546785 PECOS PAC ID: 3173021128 Enrollment ID: I20250809000386 |
| Provider Name | Amit Barua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710620760 PECOS PAC ID: 9638514086 Enrollment ID: I20250813001667 |
| Provider Name | Eric David Sassu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093452666 PECOS PAC ID: 7810491461 Enrollment ID: I20250917003612 |
| Provider Name | Kareem Elsayed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255828216 PECOS PAC ID: 9931562204 Enrollment ID: I20250917003696 |
| Provider Name | Kemba Hazeley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811505928 PECOS PAC ID: 2860802576 Enrollment ID: I20251205003049 |
| Provider Name | Ashkan Mowla |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659607190 PECOS PAC ID: 1951535483 Enrollment ID: I20251209000073 |
| Provider Name | Jennifer Quagliano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033801741 PECOS PAC ID: 8426544149 Enrollment ID: I20260102000408 |
| Provider Name | Karen Yencho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811165145 PECOS PAC ID: 0840577359 Enrollment ID: I20260109000269 |
| Provider Name | Shirin Hund |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245684984 PECOS PAC ID: 5597055178 Enrollment ID: I20260113001585 |
| Provider Name | Hannah Helene Shaker Breit |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669827606 PECOS PAC ID: 5294027181 Enrollment ID: I20260202000008 |
| Provider Name | Monica Erwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124817432 PECOS PAC ID: 7911472139 Enrollment ID: I20260406002285 |
| Provider Name | Miranda Zielinski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710736061 PECOS PAC ID: 3072050657 Enrollment ID: I20260428000772 |
| Provider Name | Solomon Khamishon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558998104 PECOS PAC ID: 2365943164 Enrollment ID: I20260526002061 |
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