| Lima Gerontology Associates Llp | |
|
340 N Middletown Rd Fair Acres Geriatric Center Lima PA 19037 | |
| (610) 565-7810 | |
| (610) 565-0546 |
| Full Name | Lima Gerontology Associates Llp |
|---|---|
| Speciality | Internal Medicine |
| Location | 340 N Middletown Rd, Lima, Pennsylvania |
| Authorized Official Name and Position | Ronald Leslie Barrios (MANAGING PARTNER LIMA GERONTOLOGY A) |
| Authorized Official Contact | 6106227159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lima Gerontology Associates Llp 1098 W Baltimore Pike Ste 3311 Media PA 19063 Ph: (610) 565-7810 | Lima Gerontology Associates Llp 340 N Middletown Rd Fair Acres Geriatric Center Lima PA 19037 Ph: (610) 565-7810 |
| NPI Number | 1013967645 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 04/25/2008 |
| Medicare PECOS PAC ID | 3274595103 |
|---|---|
| Medicare Enrollment ID | O20041102000658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013967645 | NPI | - | NPPES |
| 1013299060001 | Medicaid | PA | |
| L11678226 | Other | PA | HIGHMARK BLUE SHIELD |
| DC5598 | Other | PALMETTO GBA | |
| DC5756 | Other | PALMETTO GBA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Richard Michael Dimonte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497863518 PECOS PAC ID: 2365430683 Enrollment ID: I20040505000451 |
| Provider Name | Ronald Leslie Barrios |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1750355681 PECOS PAC ID: 2567425051 Enrollment ID: I20041105000591 |
| Provider Name | Vsevolod Kohutiak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366410854 PECOS PAC ID: 5294798799 Enrollment ID: I20041109000010 |
| Provider Name | Trina Louise Bradburd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215943568 PECOS PAC ID: 5698771905 Enrollment ID: I20061010000491 |
| Provider Name | Kathleen Coulter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487629663 PECOS PAC ID: 6305977489 Enrollment ID: I20100707000055 |
| Provider Name | Lauren Marci Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043661325 PECOS PAC ID: 1052606852 Enrollment ID: I20160818000043 |