| Terranova Medical, Pllc | |
|
778 White Plains Rd Scarsdale NY 10583-5005 | |
| (914) 574-6161 | |
| (914) 340-0740 |
| Full Name | Terranova Medical, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 778 White Plains Rd, Scarsdale, New York |
| Authorized Official Name and Position | Santo Primo Terranova (OWNER) |
| Authorized Official Contact | 9145746161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terranova Medical, Pllc 778 White Plains Rd Scarsdale NY 10583-5005 Ph: (914) 574-6161 | Terranova Medical, Pllc 778 White Plains Rd Scarsdale NY 10583-5005 Ph: (914) 574-6161 |
| NPI Number | 1164143046 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 09/08/2022 |
| Certification Date | 09/08/2022 |
| Medicare PECOS PAC ID | 7315313566 |
|---|---|
| Medicare Enrollment ID | O20221013001276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164143046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Santo Primo Terranova |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982865358 PECOS PAC ID: 7911191937 Enrollment ID: I20101103000472 |
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