| Dr Vezza Medical Services PC | |
|
3594 E Tremont Ave Ste 100 Bronx NY 10465-2032 | |
| (212) 734-6621 | |
| (516) 430-5031 |
| Full Name | Dr Vezza Medical Services PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3594 E Tremont Ave Ste 100, Bronx, New York |
| Authorized Official Name and Position | Elana Lorraine Vezza (OWNER) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Vezza Medical Services PC 885 3rd Ave Fl 28 New York NY 10022-4834 Ph: (212) 734-6621 | Dr Vezza Medical Services PC 3594 E Tremont Ave Ste 100 Bronx NY 10465-2032 Ph: (212) 734-6621 |
| NPI Number | 1720560741 |
|---|---|
| Provider Enumeration Date | 09/06/2018 |
| Last Update Date | 06/19/2025 |
| Certification Date | 06/19/2025 |
| Medicare PECOS PAC ID | 8921342072 |
|---|---|
| Medicare Enrollment ID | O20181130001743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720560741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 169234 (New York) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 169234 (New York) | Secondary |
| Provider Name | Elena L Vezza |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033161021 PECOS PAC ID: 6800874041 Enrollment ID: I20040713000632 |
| Provider Name | Stacy Macfarlane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043583032 PECOS PAC ID: 0244478527 Enrollment ID: I20181221001636 |
| Provider Name | Lalia Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831736552 PECOS PAC ID: 3779911755 Enrollment ID: I20200325003016 |
| Provider Name | Richard Gordon Nellis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649438516 PECOS PAC ID: 2567520083 Enrollment ID: I20211103000312 |
| Provider Name | Bridgett Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629580519 PECOS PAC ID: 3375931702 Enrollment ID: I20230216001773 |
| Provider Name | Cassandra Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215509401 PECOS PAC ID: 9032512330 Enrollment ID: I20231117002289 |
| Provider Name | Jessica Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821675158 PECOS PAC ID: 5395145593 Enrollment ID: I20240329002017 |
| Provider Name | Pauline Delinois |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275183931 PECOS PAC ID: 1658785142 Enrollment ID: I20240611002868 |
| Provider Name | Elsa Frederic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376933192 PECOS PAC ID: 2163815002 Enrollment ID: I20240719001741 |
| Provider Name | Mesfin Tadesse Frew |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962760199 PECOS PAC ID: 4880839158 Enrollment ID: I20241022003666 |
| Provider Name | Brandon Soule |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689962581 PECOS PAC ID: 3870765340 Enrollment ID: I20241119001005 |
| Provider Name | Chidi Obinani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891962106 PECOS PAC ID: 5294806816 Enrollment ID: I20241206002659 |
| Provider Name | Mariya Tankimovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386937514 PECOS PAC ID: 3375715055 Enrollment ID: I20250114000330 |
| Provider Name | Jeffrey Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942226824 PECOS PAC ID: 6800869629 Enrollment ID: I20250124002403 |
| Provider Name | Sophia Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609248152 PECOS PAC ID: 5597120733 Enrollment ID: I20250207002500 |
| Provider Name | Tacara Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053922294 PECOS PAC ID: 4284041914 Enrollment ID: I20250221003356 |
| Provider Name | Kristina Jean Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730530908 PECOS PAC ID: 9234491283 Enrollment ID: I20250224000980 |
| Provider Name | Prisca Okwara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942919667 PECOS PAC ID: 4789054529 Enrollment ID: I20250224001511 |
| Provider Name | Glen Rebman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487181558 PECOS PAC ID: 4385998715 Enrollment ID: I20250723003484 |
| Provider Name | Stacey Hyles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366799512 PECOS PAC ID: 6901051283 Enrollment ID: I20250807001002 |
| Provider Name | Joseph Fagbohun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033497771 PECOS PAC ID: 1153428065 Enrollment ID: I20250814000890 |
| Provider Name | Karina Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255006326 PECOS PAC ID: 2466859541 Enrollment ID: I20250910001121 |
| Provider Name | Pooja Shah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770322042 PECOS PAC ID: 0840707964 Enrollment ID: I20251031001502 |
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