| Integrated Medicine Alliance Pa | |
|
30 Shrewsbury Plz Shrewsbury NJ 07702-4322 | |
| (732) 460-9840 | |
| (732) 460-9848 |
| Full Name | Integrated Medicine Alliance Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 30 Shrewsbury Plz, Shrewsbury, New Jersey |
| Authorized Official Name and Position | Jan S Glowacki (TREASURER) |
| Authorized Official Contact | 7324609840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Medicine Alliance Pa Po Box 8519 Red Bank NJ 07701-8519 Ph: (732) 460-9840 | Integrated Medicine Alliance Pa 30 Shrewsbury Plz Shrewsbury NJ 07702-4322 Ph: (732) 460-9840 |
| NPI Number | 1649252776 |
|---|---|
| Provider Enumeration Date | 11/15/2005 |
| Last Update Date | 12/02/2009 |
| Medicare PECOS PAC ID | 2668468919 |
|---|---|
| Medicare Enrollment ID | O20040422000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649252776 | NPI | - | NPPES |
| CA1204 | Other | MEDICARE RAILROAD | |
| 3259501 | Medicaid | NJ | |
| J020393 | Other | CHAMPUS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Peter C Valko |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528003159 PECOS PAC ID: 1759362478 Enrollment ID: I20040528000039 |
| Provider Name | Ziad A Abbud |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740373489 PECOS PAC ID: 4587627344 Enrollment ID: I20041112000410 |
| Provider Name | Robert P Chen |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1447276233 PECOS PAC ID: 3072595610 Enrollment ID: I20041207000431 |
| Provider Name | Caryn M Giacona |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982686010 PECOS PAC ID: 4587617352 Enrollment ID: I20050222000529 |
| Provider Name | Elizabeth O Salcedo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396840013 PECOS PAC ID: 7719973437 Enrollment ID: I20050617000089 |
| Provider Name | Charles L Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770565251 PECOS PAC ID: 9234165978 Enrollment ID: I20051004000136 |
| Provider Name | Denise H Hayward |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881669950 PECOS PAC ID: 8729071634 Enrollment ID: I20061121000292 |
| Provider Name | Elizabeth S Gredell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851566525 PECOS PAC ID: 6002980265 Enrollment ID: I20080806000120 |
| Provider Name | Shanda M Mcmanus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487862827 PECOS PAC ID: 3779645130 Enrollment ID: I20081218000196 |
| Provider Name | Dominic C Pamintuan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124034897 PECOS PAC ID: 7517963291 Enrollment ID: I20100503000034 |
| Provider Name | Ahmad John Haddad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982686457 PECOS PAC ID: 4789610429 Enrollment ID: I20110221000250 |
| Provider Name | Lizett A. Marza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447232582 PECOS PAC ID: 4587733845 Enrollment ID: I20110221000660 |
| Provider Name | Brendan J Mulholland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922080092 PECOS PAC ID: 3779519418 Enrollment ID: I20110228000062 |
| Provider Name | Nafisa Y Bhoori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811979941 PECOS PAC ID: 8325229040 Enrollment ID: I20110228000768 |
| Provider Name | Victoria Triola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124000112 PECOS PAC ID: 8921289646 Enrollment ID: I20110228000819 |
| Provider Name | Laith Zamel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336467844 PECOS PAC ID: 1254513781 Enrollment ID: I20110304000497 |
| Provider Name | Roger M Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376526442 PECOS PAC ID: 4587690227 Enrollment ID: I20110318000681 |
| Provider Name | Dana L Essner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952503393 PECOS PAC ID: 8426221706 Enrollment ID: I20111102000105 |
| Provider Name | David S Zukoff |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023089778 PECOS PAC ID: 8426295049 Enrollment ID: I20130518000009 |
| Provider Name | Jamie L White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851796155 PECOS PAC ID: 8820312333 Enrollment ID: I20150109001098 |
| Provider Name | Mark Zaky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780950675 PECOS PAC ID: 7618280587 Enrollment ID: I20150721002019 |
| Provider Name | Kristine Mccoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922105394 PECOS PAC ID: 5496858219 Enrollment ID: I20160513001150 |
| Provider Name | Mallika Bhat |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1811221807 PECOS PAC ID: 9931334612 Enrollment ID: I20170509000087 |
| Provider Name | Shiela Reno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649783416 PECOS PAC ID: 7214298777 Enrollment ID: I20180223001477 |
| Provider Name | Karen Scherer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639623317 PECOS PAC ID: 7416218300 Enrollment ID: I20180312001057 |
| Provider Name | Jaimee Bogdon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679054225 PECOS PAC ID: 9830442433 Enrollment ID: I20181029002717 |
| Provider Name | Alexis M Totten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770064362 PECOS PAC ID: 8325391709 Enrollment ID: I20181101001353 |
| Provider Name | Colleen Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821559253 PECOS PAC ID: 8921332974 Enrollment ID: I20190625000989 |
| Provider Name | Therese Piasecki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811469703 PECOS PAC ID: 9537498548 Enrollment ID: I20190916003064 |
| Provider Name | Yevgeniy Vaynkof |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558707620 PECOS PAC ID: 7911295837 Enrollment ID: I20210302001781 |
| Provider Name | Andrew Fouchey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992307060 PECOS PAC ID: 4880001643 Enrollment ID: I20210324000862 |
| Provider Name | Mariam Ibrahim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558899443 PECOS PAC ID: 6800290826 Enrollment ID: I20210812000530 |
| Provider Name | Emily Eyerkuss |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699214759 PECOS PAC ID: 7517347115 Enrollment ID: I20220628003857 |
| Provider Name | Mina M Soliman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780175919 PECOS PAC ID: 5890178115 Enrollment ID: I20220819001006 |
| Provider Name | Conor Martin Mulholland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760154827 PECOS PAC ID: 3779968102 Enrollment ID: I20220921000040 |
| Provider Name | Regina E Opare-sem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386399632 PECOS PAC ID: 6507230356 Enrollment ID: I20230320000430 |
Rajaraman Medicine & Pediatrics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 59 Avenue At The Cmn, Suite#105, Shrewsbury, NJ 07702 Phone: 732-544-8899 | |
Morganville Medical Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 Avenue At The Commons, Suite 2, Shrewsbury, NJ 07702 Phone: 732-544-5551 Fax: 732-544-5559 | |
Kaiser Fitness And Medispa Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 555 Shrewsbury Ave, Suite F, Shrewsbury, NJ 07702 Phone: 732-758-8251 Fax: 732-758-8250 | |
Odell Family Practice, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 Avenue At The Cmn Ste 2, Shrewsbury, NJ 07702 Phone: 732-460-1313 Fax: 732-460-1333 | |
Preventive Medicine Of Monmouth Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 Shrewsbury Ave, Shrewsbury, NJ 07702 Phone: 732-219-0894 Fax: 732-219-0896 | |
Willard H Cook, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 59 Avenue At The Cmn, Shrewsbury, NJ 07702 Phone: 732-542-7013 Fax: 732-542-0991 |