| Personal Primary Care And Weight Management, Llc | |
|
299 Carew St Ste 234 Springfield MA 01104-2368 | |
| (413) 787-2575 | |
| (413) 787-2576 |
| Full Name | Personal Primary Care And Weight Management, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 299 Carew St Ste 234, Springfield, Massachusetts |
| Authorized Official Name and Position | Talal Khan (CEO) |
| Authorized Official Contact | 4138463337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personal Primary Care And Weight Management, Llc 222 Carew St Ste. 301 Springfield MA 01104-4109 Ph: (413) 732-4478 | Personal Primary Care And Weight Management, Llc 299 Carew St Ste 234 Springfield MA 01104-2368 Ph: (413) 787-2575 |
| NPI Number | 1376068817 |
|---|---|
| Provider Enumeration Date | 08/05/2017 |
| Last Update Date | 11/20/2017 |
| Medicare PECOS PAC ID | 3577821875 |
|---|---|
| Medicare Enrollment ID | O20171214000991 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376068817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Talal N Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861406613 PECOS PAC ID: 1658302377 Enrollment ID: I20090917000432 |
| Provider Name | Hassen M Borhot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457660029 PECOS PAC ID: 2961698493 Enrollment ID: I20101123001001 |
| Provider Name | Julyvette Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710376934 PECOS PAC ID: 7618277781 Enrollment ID: I20151120001099 |
| Provider Name | Nidah T Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629418850 PECOS PAC ID: 7012299324 Enrollment ID: I20170123000302 |
| Provider Name | Brianna Lois Zalewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497455372 PECOS PAC ID: 7012372592 Enrollment ID: I20230505001812 |
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