| Pedirite Medical Va Pllc | |
|
831 E Ellerslie Ave Colonial Heights VA 23834-1720 | |
| (212) 764-0008 | |
| Not Available |
| Full Name | Pedirite Medical Va Pllc |
|---|---|
| Speciality | General Practice |
| Location | 831 E Ellerslie Ave, Colonial Heights, Virginia |
| Authorized Official Name and Position | Sol Klein (MEMBER) |
| Authorized Official Contact | 2127640008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pedirite Medical Va Pllc 267 Broadway Fl 2 Brooklyn NY 11211-6216 Ph: () - | Pedirite Medical Va Pllc 831 E Ellerslie Ave Colonial Heights VA 23834-1720 Ph: (212) 764-0008 |
| NPI Number | 1851962229 |
|---|---|
| Provider Enumeration Date | 07/07/2021 |
| Last Update Date | 07/07/2021 |
| Medicare PECOS PAC ID | 3072916907 |
|---|---|
| Medicare Enrollment ID | O20210729000781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851962229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Monique Muronda |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003078213 PECOS PAC ID: 2365614443 Enrollment ID: I20151105002449 |
| Provider Name | Ehsan A Khan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1598149734 PECOS PAC ID: 5991059230 Enrollment ID: I20181126001996 |
| Provider Name | Carlos Myers |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790210664 PECOS PAC ID: 0042554370 Enrollment ID: I20181127003201 |
| Provider Name | Yun Pan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457845562 PECOS PAC ID: 4587071998 Enrollment ID: I20210401000225 |
| Provider Name | Caroline N Mpande |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1679914436 PECOS PAC ID: 2567778244 Enrollment ID: I20210908000731 |
| Provider Name | Sara Mahmood |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1366978983 PECOS PAC ID: 5698044337 Enrollment ID: I20220526002902 |
| Provider Name | Nastassia Brown |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1447818307 PECOS PAC ID: 2365777505 Enrollment ID: I20231117000028 |
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