| Delaware Valley Hospital, Inc | |
|
2 Titus Pl Walton NY 13856-1455 | |
| (607) 865-2400 | |
| Not Available |
| Full Name | Delaware Valley Hospital, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2 Titus Pl, Walton, New York |
| Authorized Official Name and Position | Rolland Bojo (PRESIDENT/CEO) |
| Authorized Official Contact | 6078652162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delaware Valley Hospital, Inc 2 Titus Pl Walton NY 13856-1455 Ph: (607) 865-2400 | Delaware Valley Hospital, Inc 2 Titus Pl Walton NY 13856-1455 Ph: (607) 865-2400 |
| NPI Number | 1144312646 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 11/06/2023 |
| Medicare PECOS PAC ID | 2860388337 |
|---|---|
| Medicare Enrollment ID | O20040223001307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144312646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QC0050X | Clinic/center - Critical Access Hospital | (* (Not Available)) | Primary |
| Provider Name | Mitchell Chess |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487602058 PECOS PAC ID: 0941101927 Enrollment ID: I20040114000493 |
| Provider Name | Margarita Gleyzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194186627 PECOS PAC ID: 6800881426 Enrollment ID: I20040414001788 |
| Provider Name | Vadim Davydov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538264346 PECOS PAC ID: 0143215871 Enrollment ID: I20040420000770 |
| Provider Name | Jane F.o. Gotthardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871716282 PECOS PAC ID: 3375531239 Enrollment ID: I20040501000129 |
| Provider Name | Merita A Bania |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790731818 PECOS PAC ID: 2062493190 Enrollment ID: I20040525001794 |
| Provider Name | Emmanuel M Guizano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942294194 PECOS PAC ID: 9830172949 Enrollment ID: I20040610000323 |
| Provider Name | Steven D Schwartz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154384766 PECOS PAC ID: 0648253617 Enrollment ID: I20040610000843 |
| Provider Name | Francis J Mangiacapra |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386612216 PECOS PAC ID: 4183695638 Enrollment ID: I20040805001389 |
| Provider Name | Valentina Davydov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568546182 PECOS PAC ID: 8123095973 Enrollment ID: I20040913000461 |
| Provider Name | Sam Berger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831118777 PECOS PAC ID: 5193787711 Enrollment ID: I20041027000248 |
| Provider Name | Lawrence Wiesner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679574123 PECOS PAC ID: 8820054927 Enrollment ID: I20041209000342 |
| Provider Name | Jeffrey Gray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730172792 PECOS PAC ID: 5991762585 Enrollment ID: I20041215000552 |
| Provider Name | Olayinka O Wilhelm |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134117138 PECOS PAC ID: 5799726055 Enrollment ID: I20050517000449 |
| Provider Name | Edward Balaci |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932177870 PECOS PAC ID: 5496785750 Enrollment ID: I20050816000873 |
| Provider Name | Gina G Puglisi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366472011 PECOS PAC ID: 3375574312 Enrollment ID: I20050829001066 |
| Provider Name | Kimberly A Crum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619998077 PECOS PAC ID: 9537186986 Enrollment ID: I20051026000103 |
| Provider Name | Thomas Gudas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609843903 PECOS PAC ID: 9032124664 Enrollment ID: I20060217000337 |
| Provider Name | Vincent Montone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023086964 PECOS PAC ID: 1052328143 Enrollment ID: I20060315000118 |
| Provider Name | Craig J Byrum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215086350 PECOS PAC ID: 7012924053 Enrollment ID: I20060321000523 |
| Provider Name | Edward Santelli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861460701 PECOS PAC ID: 7113935693 Enrollment ID: I20060328000010 |
| Provider Name | Mohammad S Ibrahim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114938404 PECOS PAC ID: 7719080522 Enrollment ID: I20070316000020 |
| Provider Name | Maura Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740345636 PECOS PAC ID: 0143321620 Enrollment ID: I20070727000536 |
| Provider Name | Keyoor Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598984668 PECOS PAC ID: 5890888630 Enrollment ID: I20070910000624 |
| Provider Name | Andrew M Goldschmidt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962470898 PECOS PAC ID: 8729171327 Enrollment ID: I20070912000174 |
| Provider Name | Zafar J Bajwa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205848611 PECOS PAC ID: 9537255575 Enrollment ID: I20071022000536 |
| Provider Name | Henda Bouali |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1053495465 PECOS PAC ID: 0648351080 Enrollment ID: I20080111000262 |
| Provider Name | Mark P Speicher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346215845 PECOS PAC ID: 0244312775 Enrollment ID: I20080123000520 |
| Provider Name | Joelle Underwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871770511 PECOS PAC ID: 5092891218 Enrollment ID: I20080327000469 |
| Provider Name | Hisham Kashou |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710988266 PECOS PAC ID: 0446323224 Enrollment ID: I20080728000232 |
| Provider Name | Ali Marhaba |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1104827138 PECOS PAC ID: 1456401157 Enrollment ID: I20090617000574 |
| Provider Name | Mark K Jackson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063405538 PECOS PAC ID: 2668523044 Enrollment ID: I20090624000621 |
| Provider Name | Harvey M Wiener |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194783761 PECOS PAC ID: 9537066311 Enrollment ID: I20100211000003 |
| Provider Name | Matthew K Reppert |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003880683 PECOS PAC ID: 1052441722 Enrollment ID: I20100608000177 |
| Provider Name | Michael T Freeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396743407 PECOS PAC ID: 7214052232 Enrollment ID: I20100915000006 |
| Provider Name | Kim Evelyn Halaquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043522170 PECOS PAC ID: 1052437027 Enrollment ID: I20100928000005 |
| Provider Name | Amit M Khaneja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922261486 PECOS PAC ID: 8123296902 Enrollment ID: I20110721000627 |
| Provider Name | Matthew Jay Egan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386770261 PECOS PAC ID: 4486826435 Enrollment ID: I20111017000547 |
| Provider Name | Piotr Sadej |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730384512 PECOS PAC ID: 9537325048 Enrollment ID: I20120730000001 |
| Provider Name | Cynthia M Cantwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184621062 PECOS PAC ID: 8820244486 Enrollment ID: I20120814000389 |
| Provider Name | Sobia Naz Mirza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952645434 PECOS PAC ID: 2466691829 Enrollment ID: I20130614000198 |
| Provider Name | Noelle Marie Buffum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699109371 PECOS PAC ID: 2860628310 Enrollment ID: I20131112000394 |
| Provider Name | James H Lim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063625291 PECOS PAC ID: 0840322038 Enrollment ID: I20150319000365 |
| Provider Name | Nabia S Ikram |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528201324 PECOS PAC ID: 0446475859 Enrollment ID: I20150917001688 |
| Provider Name | Britton M Chan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144455072 PECOS PAC ID: 0547573578 Enrollment ID: I20160817001494 |
| Provider Name | Muhammad I Ali |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1861659351 PECOS PAC ID: 9931342920 Enrollment ID: I20161123000514 |
| Provider Name | Amanke Chigozie Oranu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750544425 PECOS PAC ID: 4082899943 Enrollment ID: I20170712003108 |
| Provider Name | Brian Tischler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265723969 PECOS PAC ID: 5294967881 Enrollment ID: I20170828001175 |
| Provider Name | Kathleen Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457889800 PECOS PAC ID: 4284909359 Enrollment ID: I20170929001849 |
| Provider Name | Gina Paek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770876898 PECOS PAC ID: 0345528857 Enrollment ID: I20171218000077 |
| Provider Name | Mohammad A Abidi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295153690 PECOS PAC ID: 8921224338 Enrollment ID: I20171222000068 |
| Provider Name | Judith Creecy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609000298 PECOS PAC ID: 0143379826 Enrollment ID: I20180529001302 |
| Provider Name | Nicholas Andrew Putrino |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407243207 PECOS PAC ID: 2163734229 Enrollment ID: I20180814003163 |
| Provider Name | Joann Sciacca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255444147 PECOS PAC ID: 0042591869 Enrollment ID: I20180824000347 |
| Provider Name | Ramsie Jade Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558840884 PECOS PAC ID: 0749531838 Enrollment ID: I20181001000065 |
| Provider Name | Eirawen Brynn Luettgen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699259002 PECOS PAC ID: 0345585436 Enrollment ID: I20181218001705 |
| Provider Name | Muhammad Anwar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265986848 PECOS PAC ID: 9830423722 Enrollment ID: I20190626002876 |
| Provider Name | Abdelhamid Ben Selma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245757392 PECOS PAC ID: 0042553646 Enrollment ID: I20200715003536 |
| Provider Name | Kirill Davidov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730600370 PECOS PAC ID: 3870836992 Enrollment ID: I20200922000551 |
| Provider Name | Minhaz Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346775996 PECOS PAC ID: 5092058669 Enrollment ID: I20200928002502 |
| Provider Name | Kabir Gandhi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629365275 PECOS PAC ID: 7810289048 Enrollment ID: I20201104002495 |
| Provider Name | Maria S Bajwa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437683299 PECOS PAC ID: 0749523017 Enrollment ID: I20210813000824 |
| Provider Name | Matthew Jacob Halloran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922648419 PECOS PAC ID: 6800293200 Enrollment ID: I20210928002680 |
| Provider Name | Kimberly Sheldon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285301465 PECOS PAC ID: 0547668964 Enrollment ID: I20211014001860 |
| Provider Name | Godson D Senyondo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801372289 PECOS PAC ID: 4688917271 Enrollment ID: I20211113000001 |
| Provider Name | Zabih Ullah Warraich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316423411 PECOS PAC ID: 9234521931 Enrollment ID: I20220107002053 |
| Provider Name | Karena Trimbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750037321 PECOS PAC ID: 1254726094 Enrollment ID: I20220315000945 |
| Provider Name | Matthew Markert |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073951539 PECOS PAC ID: 4981902699 Enrollment ID: I20220502000402 |
| Provider Name | Shakthi Nandan Sureddi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114421336 PECOS PAC ID: 2365787173 Enrollment ID: I20221110000075 |
| Provider Name | Shasta Treadway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245953959 PECOS PAC ID: 1658749031 Enrollment ID: I20221115003019 |
| Provider Name | Waleed Raheem Abood Abood |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083065148 PECOS PAC ID: 8921391624 Enrollment ID: I20230222000703 |
| Provider Name | Grace Mae Bartolillo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780348383 PECOS PAC ID: 9931378858 Enrollment ID: I20230310001619 |
| Provider Name | Erica Marie Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114550415 PECOS PAC ID: 6709215858 Enrollment ID: I20230911002150 |
| Provider Name | Tara Darling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831867035 PECOS PAC ID: 9931554482 Enrollment ID: I20231018002323 |
| Provider Name | Stephanie Enner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093247421 PECOS PAC ID: 5294072815 Enrollment ID: I20231108002381 |
| Provider Name | Brandon Tominna |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801087374 PECOS PAC ID: 5991855678 Enrollment ID: I20240403003137 |
| Provider Name | Salman Sikandar Mirza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093722308 PECOS PAC ID: 7810029436 Enrollment ID: I20240412001562 |
| Provider Name | Salman Zafar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366930703 PECOS PAC ID: 9436494663 Enrollment ID: I20240726001735 |
| Provider Name | Jonathan Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033407499 PECOS PAC ID: 2860776762 Enrollment ID: I20240911003417 |
| Provider Name | Emily J Seymour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275201477 PECOS PAC ID: 6800329293 Enrollment ID: I20241114003637 |
Mary Imogene Bassett Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 North St, Walton, NY 13856 Phone: 607-865-6541 Fax: 607-865-9164 |