| Tri America Tmsketa Llc | |
|
2185 Lemoine Ave Unit 1h Fort Lee NJ 07024-6030 | |
| (888) 701-6472 | |
| Not Available |
| Full Name | Tri America Tmsketa Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2185 Lemoine Ave Unit 1h, Fort Lee, New Jersey |
| Authorized Official Name and Position | Lori Kolin (AUTHORIZED PERSON) |
| Authorized Official Contact | 8887016472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri America Tmsketa Llc 2185 Lemoine Ave Unit 1h Fort Lee NJ 07024-6030 Ph: (888) 701-6472 | Tri America Tmsketa Llc 2185 Lemoine Ave Unit 1h Fort Lee NJ 07024-6030 Ph: (888) 701-6472 |
| NPI Number | 1417612250 |
|---|---|
| Provider Enumeration Date | 11/06/2021 |
| Last Update Date | 02/13/2025 |
| Certification Date | 02/13/2025 |
| Medicare PECOS PAC ID | 8628462397 |
|---|---|
| Medicare Enrollment ID | O20220222001798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417612250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Magdalena Spariosu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467472050 PECOS PAC ID: 1355498726 Enrollment ID: I20110531000177 |
| Provider Name | Christopher R Richards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952631715 PECOS PAC ID: 0648401927 Enrollment ID: I20140331000641 |
| Provider Name | Erika Masias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619337276 PECOS PAC ID: 3476826827 Enrollment ID: I20170906002247 |
| Provider Name | Anatoly Maloletkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215724539 PECOS PAC ID: 5799202321 Enrollment ID: I20250507002537 |
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