| Stefani Tica, | |
|
9200 Calumet Ave # 203, Munster, IN 46321-2885 | |
| (219) 228-4200 | |
| Not Available |
| Full Name | Stefani Tica |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 9200 Calumet Ave # 203, Munster, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033739271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Entity Name | Dermio Dermatology LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811402423 PECOS PAC ID: 7315206687 Enrollment ID: O20180111002019 |
| Mailing Address | Practice Location Address |
|---|---|
| Stefani Tica, 9200 Calumet Ave # 203, Munster, IN 46321-2885 Ph: (219) 228-4200 | Stefani Tica, 9200 Calumet Ave # 203, Munster, IN 46321-2885 Ph: (219) 228-4200 |
Darcy Winston, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 901 Macarthur Blvd, Munster, IN 46321 Phone: 219-836-1600 |
Danielle Dominique Romero, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 8135 Calumet Ave, Munster, IN 46321 Phone: 219-513-2000 |
Amy Berghoff, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9900 Columbia Ave, Munster, IN 46321 Phone: 219-924-3300 Fax: 219-934-2658 |
Michael A Krzyskowski, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9900 Columbia Ave, Munster, IN 46321 Phone: 121-992-4330 Fax: 219-934-2658 |
Allyson Caisley, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 801 Macarthur Blvd Ste 305, Munster, IN 46321 Phone: 219-703-2401 Fax: 219-703-6687 |
Reeya Brahmbhatt, Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 701 Superior Ave, Munster, IN 46321 Phone: 219-922-4200 |
Ms. Erin Kathleen Martin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 801 Macarthur Blvd, Suite 204, Munster, IN 46321 Phone: 219-836-4220 Fax: 219-836-4171 |