| Family Practice Group Pc | |
|
11 Water St Suite 1a Arlington MA 02476-4812 | |
| (781) 648-9700 | |
| (781) 648-0234 |
| Full Name | Family Practice Group Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 11 Water St, Arlington, Massachusetts |
| Authorized Official Name and Position | Jennifer Hillery (ADMINISTRATOR) |
| Authorized Official Contact | 7816489700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Group Pc 11 Water St Suite 1a Arlington MA 02476-4812 Ph: (781) 648-9700 | Family Practice Group Pc 11 Water St Suite 1a Arlington MA 02476-4812 Ph: (781) 648-9700 |
| NPI Number | 1801953849 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 07/16/2010 |
| Medicare PECOS PAC ID | 5395717920 |
|---|---|
| Medicare Enrollment ID | O20040812000708 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801953849 | NPI | - | NPPES |
| 9711635 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Wayne J Altman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568463479 PECOS PAC ID: 5092787648 Enrollment ID: I20040812000827 |
| Provider Name | Parra Tomkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366433666 PECOS PAC ID: 9931141090 Enrollment ID: I20050531000037 |
| Provider Name | Brian R Penti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003921065 PECOS PAC ID: 5294826376 Enrollment ID: I20070803000021 |
| Provider Name | Peter Mcentee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659438059 PECOS PAC ID: 5890882013 Enrollment ID: I20071103000047 |
| Provider Name | Elly Tsai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346404563 PECOS PAC ID: 0345309761 Enrollment ID: I20081030000125 |
| Provider Name | Laura Beth Zucker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396745766 PECOS PAC ID: 2264613447 Enrollment ID: I20110221000950 |
| Provider Name | Caitlin Trilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104229442 PECOS PAC ID: 2961724935 Enrollment ID: I20141202000277 |
| Provider Name | Andrew Chandler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548607112 PECOS PAC ID: 0042514986 Enrollment ID: I20160714001027 |
| Provider Name | Shravya Budidi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144761438 PECOS PAC ID: 4688944515 Enrollment ID: I20210709000850 |
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