| Brooke A Raveendranath, NP | |
| 
					6 Executive Park Dr, Albany, NY 12203-3791  | |
| (518) 641-6319 | |
| (518) 641-6850 | 
| Full Name | Brooke A Raveendranath | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Pediatrics | 
| Location | 6 Executive Park Dr, Albany, New York | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1891849618 | NPI | - | NPPES | 
| 02848268 | Medicaid | NY | |
| 000420465001 | Other | NY | BSNENY | 
| 3010992 | Other | NY | MVP HEALTHCARE | 
| 143259 | Other | NY | GHI-HMO | 
| 091210000047 | Other | NY | FIDELIS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | 381788 (New York) | Primary | 
| Entity Name | St Peters Hospital Of The City Of Albany | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1518042357 PECOS PAC ID: 2668460072 Enrollment ID: O20040504001301  | 
| Entity Name | St. Peter's Health Partners Medical Associates, P.c. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1750626834 PECOS PAC ID: 6103061189 Enrollment ID: O20130321000567  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Brooke A Raveendranath, NP Po Box 14890, Albany, NY 12212-4890 Ph: (518) 525-5634  | Brooke A Raveendranath, NP 6 Executive Park Dr, Albany, NY 12203-3791 Ph: (518) 641-6319  | 
Denise Ayers,  Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 75 New Scotland Ave, Albany, NY 12208 Phone: 518-447-9611  | |
Natalia Gyorke, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 121 Everett Rd, Albany, NY 12205 Phone: 518-453-9088 Fax: 518-689-6111  | |
Ms. Veronica Elaine Striffler, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1375 Washington Ave Ste 101, Albany, NY 12206 Phone: 518-438-4483 Fax: 518-482-4201  | |
Courtney Cassandra Peck, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6 Executive Park Dr, Albany, NY 12203 Phone: 518-641-6319 Fax: 518-641-6850  | |
Ms. Susan E Macknair, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 62 Hackett Blvd, Albany, NY 12209 Phone: 518-465-3318 Fax: 518-272-7458  | |
Robin M Gray, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 47 New Scotland Ave, Albany, NY 12208 Phone: 518-262-3480 Fax: 518-262-0135  | |
Kelly Irwin Pagnotti, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 315 S Manning Blvd, Albany, NY 12208 Phone: 518-525-1550  |