| Avellina Inc. | |
|
2375 Woodward St Philadelphia PA 19115-5120 | |
| (215) 676-9223 | |
| Not Available |
| Full Name | Avellina Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2375 Woodward St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Violetta Berdichevskaya (OWNER) |
| Authorized Official Contact | 2159381353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avellina Inc. Po Box 1628 Horsham PA 19044-6628 Ph: (215) 830-9991 | Avellina Inc. 2375 Woodward St Philadelphia PA 19115-5120 Ph: (215) 676-9223 |
| NPI Number | 1285805507 |
|---|---|
| Provider Enumeration Date | 03/14/2008 |
| Last Update Date | 03/25/2015 |
| Medicare PECOS PAC ID | 4385715788 |
|---|---|
| Medicare Enrollment ID | O20080612000238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285805507 | NPI | - | NPPES |
| 0019378550006 | Medicaid | PA | |
| 001642076 | Other | PA | BLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Pennsylvania) | Primary |
| Provider Name | Violetta Berdichevskaya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104882646 PECOS PAC ID: 3476454398 Enrollment ID: I20040115000040 |
| Provider Name | Hanh-nhon Doan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497829402 PECOS PAC ID: 8820061138 Enrollment ID: I20040816000692 |
| Provider Name | Monika Vansant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962441683 PECOS PAC ID: 7012986771 Enrollment ID: I20040929000506 |
| Provider Name | Kira Shteinberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073712238 PECOS PAC ID: 4385729755 Enrollment ID: I20080310000266 |
| Provider Name | Elena Annopolsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316900798 PECOS PAC ID: 3971797861 Enrollment ID: I20101104000926 |
| Provider Name | Antoinette Dowds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477598209 PECOS PAC ID: 8123217197 Enrollment ID: I20110106000053 |
| Provider Name | Ksenia Smirnov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346680519 PECOS PAC ID: 1153565858 Enrollment ID: I20130919000435 |
| Provider Name | Elena Konakova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124449434 PECOS PAC ID: 4587897087 Enrollment ID: I20140508000547 |
| Provider Name | Maria Golow |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619256492 PECOS PAC ID: 8820214679 Enrollment ID: I20140731000116 |
| Provider Name | Rachel Gennaoui Abad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497093595 PECOS PAC ID: 0042454928 Enrollment ID: I20151005001966 |
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