| Advanced Lipidology | |
|
N27w23953 Paul Rd Ste 101 Pewaukee WI 53072-6243 | |
| (262) 646-3223 | |
| (262) 646-3443 |
| Full Name | Advanced Lipidology |
|---|---|
| Speciality | Clinical Nurse Specialist |
| Location | N27w23953 Paul Rd, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Pauline F Haririe (PRESIDENT) |
| Authorized Official Contact | 2626463223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Lipidology N27w23953 Paul Rd Ste 101 Pewaukee WI 53072-6243 Ph: (262) 646-3223 | Advanced Lipidology N27w23953 Paul Rd Ste 101 Pewaukee WI 53072-6243 Ph: (262) 646-3223 |
| NPI Number | 1639504004 |
|---|---|
| Provider Enumeration Date | 09/04/2013 |
| Last Update Date | 08/31/2018 |
| Medicare PECOS PAC ID | 7911121991 |
|---|---|
| Medicare Enrollment ID | O20140612001973 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639504004 | NPI | - | NPPES |
| 465050072 | Other | WI | MEDICARE |
| 36001800 | Medicaid | WI | |
| 029770069 | Other | WI | MEDICARE |
| Provider Name | Pauline F Haririe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508800624 PECOS PAC ID: 9234215393 Enrollment ID: I20080329000004 |
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