| Platinum Providers Group LLC | |
|
1418 New Rd Ste 1 Northfield NJ 08225-1179 | |
| (609) 796-7969 | |
| (609) 642-2663 |
| Full Name | Platinum Providers Group LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1418 New Rd Ste 1, Northfield, New Jersey |
| Authorized Official Name and Position | Athanasios G. Papastamelos (MANAGING MEMBER) |
| Authorized Official Contact | 6094691585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Platinum Providers Group LLC 2106 New Rd Ste F2 Linwood NJ 08221-1053 Ph: (609) 796-7969 | Platinum Providers Group LLC 1418 New Rd Ste 1 Northfield NJ 08225-1179 Ph: (609) 796-7969 |
| NPI Number | 1457080178 |
|---|---|
| Provider Enumeration Date | 06/08/2022 |
| Last Update Date | 07/15/2026 |
| Certification Date | 07/15/2026 |
| Medicare PECOS PAC ID | 5890114821 |
|---|---|
| Medicare Enrollment ID | O20200924002177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457080178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Arthur G Nahas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447446158 PECOS PAC ID: 1658267059 Enrollment ID: I20040224000147 |
| Provider Name | Deborah Kim Parlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508917832 PECOS PAC ID: 8224097886 Enrollment ID: I20041008000234 |
| Provider Name | Barbara Greenling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467480715 PECOS PAC ID: 1759345184 Enrollment ID: I20041116000617 |
| Provider Name | Michael F Lurakis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437228178 PECOS PAC ID: 0547299190 Enrollment ID: I20050804000616 |
| Provider Name | Cherry Pie Venzon Tiu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346683802 PECOS PAC ID: 6901044072 Enrollment ID: I20130531000019 |
| Provider Name | Gary Lee Oxenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346214533 PECOS PAC ID: 7315990082 Enrollment ID: I20190411003108 |
| Provider Name | Jessica Dybus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386343655 PECOS PAC ID: 4486095437 Enrollment ID: I20240508003433 |
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