| Catherine Sundholm, | |
|
201 Berdan Ave, Wayne, NJ 07470-3236 | |
| (201) 612-9988 | |
| (201) 445-9050 |
| Full Name | Catherine Sundholm |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 201 Berdan Ave, Wayne, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366211724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 25MP00809900 (New Jersey) | Primary |
| Entity Name | Practice Associates Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427016385 PECOS PAC ID: 5890703177 Enrollment ID: O20060330000690 |
| Entity Name | Ihpnj ER LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225750946 PECOS PAC ID: 3870963168 Enrollment ID: O20230103000314 |
| Mailing Address | Practice Location Address |
|---|---|
| Catherine Sundholm, Po Box 416457, Boston, MA 02241-6457 Ph: (844) 362-1735 | Catherine Sundholm, 201 Berdan Ave, Wayne, NJ 07470-3236 Ph: (201) 612-9988 |
Nicole Ariel Dable, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 20 Braemar Dr, Wayne, NJ 07470 Phone: 973-567-9867 |
Rachel Anne Hartwick, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 504 Valley Rd Ste 201, Wayne, NJ 07470 Phone: 973-446-7500 |
Talia Grace Szymanski, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 330 Ratzer Rd Ste B13, Wayne, NJ 07470 Phone: 973-317-0155 Fax: 973-694-6702 |
Natacha Derival, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1700 Nj-23 # 170, Wayne, NJ 07470 Phone: 732-338-7202 |
Lisa Beth Kogan, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 145 Route 46 W, Suite 304, Wayne, NJ 07470 Phone: 973-826-8299 Fax: 866-760-4555 |
Mrs. Dana Gabrielle Garcia, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1777 Hamburg Tpke, Suite 305, Wayne, NJ 07470 Phone: 973-831-6666 Fax: 973-831-8661 |
Ms. Cindy Ann Burns, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1784 Hamburg Tpke, Wayne, NJ 07470 Phone: 973-831-9925 Fax: 973-831-9926 |