| Genesis Elder Care Physician Services Llc | |
|
660 Commonwealth Avenue Warwick RI 02886-2707 | |
| (401) 739-4241 | |
| (401) 732-3358 |
| Full Name | Genesis Elder Care Physician Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 660 Commonwealth Avenue, Warwick, Rhode Island |
| Authorized Official Name and Position | Margaret Jean Baker (DIR OF BUS OPS) |
| Authorized Official Contact | 4104947607 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Elder Care Physician Services Llc Po Box 42738 Towson MD 21284-2738 Ph: (860) 687-3629 | Genesis Elder Care Physician Services Llc 660 Commonwealth Avenue Warwick RI 02886-2707 Ph: (401) 739-4241 |
| NPI Number | 1194774943 |
|---|---|
| Provider Enumeration Date | 05/09/2006 |
| Last Update Date | 04/12/2018 |
| Medicare PECOS PAC ID | 9830002534 |
|---|---|
| Medicare Enrollment ID | O20060510000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194774943 | NPI | - | NPPES |
| 9004790 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 363LG0600X | Nurse Practitioner - Gerontology | NPP37084 (Rhode Island) | Secondary |
| Provider Name | Sumaira Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841236270 PECOS PAC ID: 6709822513 Enrollment ID: I20050701000529 |
| Provider Name | Elizabeth Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023267580 PECOS PAC ID: 0143381954 Enrollment ID: I20110803000531 |
| Provider Name | Laura L Lamiroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649449489 PECOS PAC ID: 3375613631 Enrollment ID: I20141016000865 |
| Provider Name | Hina Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346437878 PECOS PAC ID: 2163681149 Enrollment ID: I20141112001297 |
| Provider Name | Analia Baptista Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699023168 PECOS PAC ID: 2668620360 Enrollment ID: I20180802003573 |
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