| Prohealth Physicians PC | |
|
3 Farm Glen Blvd Prohealth Physicians Farmington CT 06032-1981 | |
| (860) 284-5200 | |
| (860) 409-4077 |
| Full Name | Prohealth Physicians PC |
|---|---|
| Speciality | Family Medicine |
| Location | 3 Farm Glen Blvd, Farmington, Connecticut |
| Authorized Official Name and Position | Joy E Hong (MD, CMO) |
| Authorized Official Contact | 8609182801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prohealth Physicians PC 3 Farm Glen Blvd Prohealth Physicians Farmington CT 06032-1981 Ph: (860) 284-5200 | Prohealth Physicians PC 3 Farm Glen Blvd Prohealth Physicians Farmington CT 06032-1981 Ph: (860) 284-5200 |
| NPI Number | 1720194053 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 05/06/2026 |
| Certification Date | 05/06/2026 |
| Medicare PECOS PAC ID | 1355246950 |
|---|---|
| Medicare Enrollment ID | O20031205000602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720194053 | NPI | - | NPPES |
| 004171659 | Other | CT | PED MEDICAID |
| 004174439 | Medicaid | CT | |
| 004174421 | Other | CT | FP MEDICAID |
| 004236073 | Other | CT | PT MEDICAID |
| C02126 | Other | CT | MEDICARE PTAN |
| Provider Name | Lisa C Alonso |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093725970 PECOS PAC ID: 5799682530 Enrollment ID: I20031218000444 |
| Provider Name | Diane Cue |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972514990 PECOS PAC ID: 6204733058 Enrollment ID: I20031218000463 |
| Provider Name | Allison H Whitaker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497767776 PECOS PAC ID: 0648177493 Enrollment ID: I20031218000471 |
| Provider Name | Allen F Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639163439 PECOS PAC ID: 9234038605 Enrollment ID: I20040105000606 |
| Provider Name | Brad a Jubelirer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205942554 PECOS PAC ID: 7416856778 Enrollment ID: I20040106000215 |
| Provider Name | Carrie Streim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972514354 PECOS PAC ID: 4385543651 Enrollment ID: I20040106000247 |
| Provider Name | Cecille Freilich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962414490 PECOS PAC ID: 6901705276 Enrollment ID: I20040106000255 |
| Provider Name | Leah G Post |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871506816 PECOS PAC ID: 0547169815 Enrollment ID: I20040106000259 |
| Provider Name | Maury R Luxemburg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174533186 PECOS PAC ID: 7517866890 Enrollment ID: I20040106000329 |
| Provider Name | Thomas G Ward |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417969841 PECOS PAC ID: 1052210101 Enrollment ID: I20040107000732 |
| Provider Name | Christopher C Lawrence |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790798742 PECOS PAC ID: 5294634366 Enrollment ID: I20040107000790 |
| Provider Name | Steven L Craig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730190737 PECOS PAC ID: 1254230329 Enrollment ID: I20040107000811 |
| Provider Name | Rosemary I Maduka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356374508 PECOS PAC ID: 2466351432 Enrollment ID: I20040108000302 |
| Provider Name | Michael D Good |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104936905 PECOS PAC ID: 5092615955 Enrollment ID: I20040109000019 |
| Provider Name | Vandana Sacheti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114930070 PECOS PAC ID: 1456251156 Enrollment ID: I20040109000782 |
| Provider Name | A E Hertzler Knox |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255344321 PECOS PAC ID: 9133020779 Enrollment ID: I20040116000678 |
| Provider Name | David G Tillinghast |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689685992 PECOS PAC ID: 4284533548 Enrollment ID: I20040116000721 |
| Provider Name | Yusra Anis Anwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992767826 PECOS PAC ID: 2668373101 Enrollment ID: I20040116000775 |
| Provider Name | Mark Tuttle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194737130 PECOS PAC ID: 3274434741 Enrollment ID: I20040116000909 |
| Provider Name | Chris Bentley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770594111 PECOS PAC ID: 7618878182 Enrollment ID: I20040116000923 |
| Provider Name | Susan Buchek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174534408 PECOS PAC ID: 9133020605 Enrollment ID: I20040116000947 |
| Provider Name | James a Ouellette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457364564 PECOS PAC ID: 8729984679 Enrollment ID: I20040116000967 |
| Provider Name | Douglas H Macgilpin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023083573 PECOS PAC ID: 8921900549 Enrollment ID: I20040123000763 |
| Provider Name | Mia F Williams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598731572 PECOS PAC ID: 2961305032 Enrollment ID: I20040128000425 |
| Provider Name | Robert S Adamenko |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629040100 PECOS PAC ID: 3072416890 Enrollment ID: I20040129000650 |
| Provider Name | Melanie a Mollica |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649281544 PECOS PAC ID: 4284527367 Enrollment ID: I20040203000855 |
| Provider Name | Michelle N Brenes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124090956 PECOS PAC ID: 5698669091 Enrollment ID: I20040209000283 |
| Provider Name | Barbara Pokorny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760495782 PECOS PAC ID: 6103710181 Enrollment ID: I20040211000043 |
| Provider Name | Karen Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881692812 PECOS PAC ID: 3375430903 Enrollment ID: I20040301000056 |
| Provider Name | J Carey Laporte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609889641 PECOS PAC ID: 7810884111 Enrollment ID: I20040302000419 |
| Provider Name | Kevin J Flanagan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013981471 PECOS PAC ID: 0143118091 Enrollment ID: I20040310000982 |
| Provider Name | Sharon G Remkiewicz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497709323 PECOS PAC ID: 4789574252 Enrollment ID: I20040318000166 |
| Provider Name | Adam E Kovalski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316906258 PECOS PAC ID: 6103716584 Enrollment ID: I20040318000947 |
| Provider Name | Robert J Brice |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831164482 PECOS PAC ID: 4789574906 Enrollment ID: I20040319000174 |
| Provider Name | Candra Smith Slatas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871504712 PECOS PAC ID: 0840180089 Enrollment ID: I20040319000366 |
| Provider Name | Nancy Hwang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447260385 PECOS PAC ID: 7810888468 Enrollment ID: I20040323000605 |
| Provider Name | Kevin L Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851362180 PECOS PAC ID: 8729070008 Enrollment ID: I20040330001122 |
| Provider Name | Sandra I Escalera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669451530 PECOS PAC ID: 9739171133 Enrollment ID: I20040402000816 |
| Provider Name | Aiste Norberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922095793 PECOS PAC ID: 2769478353 Enrollment ID: I20040421000146 |
| Provider Name | Christina a Plantier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043394083 PECOS PAC ID: 6103739941 Enrollment ID: I20040428000532 |
| Provider Name | John B Trouern-trend |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124039466 PECOS PAC ID: 2365439445 Enrollment ID: I20040429000870 |
| Provider Name | Correne L Boucher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659382000 PECOS PAC ID: 9032108923 Enrollment ID: I20040506001515 |
| Provider Name | Nirmala Ramadhar- Persaud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801872528 PECOS PAC ID: 3870582331 Enrollment ID: I20040510000872 |
| Provider Name | Karen E Coblens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063479848 PECOS PAC ID: 6204825342 Enrollment ID: I20040512000424 |
| Provider Name | Gerald Bayona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780695692 PECOS PAC ID: 5193715381 Enrollment ID: I20040518000858 |
| Provider Name | Steven C Lieu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629001300 PECOS PAC ID: 2668452673 Enrollment ID: I20040721000850 |
| Provider Name | Tanya R Bilchik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881668101 PECOS PAC ID: 1850361635 Enrollment ID: I20040729000016 |
| Provider Name | Joann M Orsatti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013012855 PECOS PAC ID: 0345213567 Enrollment ID: I20040817000106 |
| Provider Name | Tina Robbins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730168634 PECOS PAC ID: 3274427752 Enrollment ID: I20040819000833 |
| Provider Name | Paul Fitch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881628147 PECOS PAC ID: 6204801228 Enrollment ID: I20040901000585 |
| Provider Name | Brooke H Kokus |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982679205 PECOS PAC ID: 6305813205 Enrollment ID: I20040910001065 |
| Provider Name | Jennifer S Violette |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992716898 PECOS PAC ID: 7810958337 Enrollment ID: I20041019000751 |
| Provider Name | Marissa a Van Hennik |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740213727 PECOS PAC ID: 5092776047 Enrollment ID: I20041022000390 |
| Provider Name | Mary E Baldino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417958364 PECOS PAC ID: 8426012949 Enrollment ID: I20041115001112 |
| Provider Name | Kurt R Stewart |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942211420 PECOS PAC ID: 6103881735 Enrollment ID: I20041123000675 |
| Provider Name | Suzanne M Powell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013905363 PECOS PAC ID: 5890751887 Enrollment ID: I20041201000836 |
| Provider Name | Amy L Baumer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104837087 PECOS PAC ID: 7315903663 Enrollment ID: I20041208000358 |
| Provider Name | Jude J Ade |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508865585 PECOS PAC ID: 7719944354 Enrollment ID: I20041215000106 |
| Provider Name | Daniel G Mussen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114939485 PECOS PAC ID: 9436101722 Enrollment ID: I20050215000559 |
| Provider Name | Lorissa R Heath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619040417 PECOS PAC ID: 6305891888 Enrollment ID: I20050317000416 |
| Provider Name | Briana M Peterson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770694945 PECOS PAC ID: 2365498284 Enrollment ID: I20050323001383 |
| Provider Name | Caroline F Kane-civitano |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952534612 PECOS PAC ID: 0345280376 Enrollment ID: I20050509000757 |
| Provider Name | Susan E Lelko |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588677553 PECOS PAC ID: 6901847706 Enrollment ID: I20050520000863 |
| Provider Name | Rebekah Pointek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144299694 PECOS PAC ID: 2860429248 Enrollment ID: I20050719000153 |
| Provider Name | Obinna I Maduka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710065917 PECOS PAC ID: 6002846409 Enrollment ID: I20050817000185 |
| Provider Name | Michelle R Foye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841255221 PECOS PAC ID: 1153351119 Enrollment ID: I20050818000895 |
| Provider Name | Dana C Ranani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275546244 PECOS PAC ID: 0042241291 Enrollment ID: I20050826000632 |
| Provider Name | Timothy E Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003860891 PECOS PAC ID: 4486671906 Enrollment ID: I20051025000027 |
| Provider Name | Richard J Sekerak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780790584 PECOS PAC ID: 5092734574 Enrollment ID: I20051114000874 |
| Provider Name | Edmund a Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881616894 PECOS PAC ID: 5698797488 Enrollment ID: I20051221000254 |
| Provider Name | Laura a Watts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326152414 PECOS PAC ID: 7113993791 Enrollment ID: I20060112000847 |
| Provider Name | Tracy a Noell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235174186 PECOS PAC ID: 0244244424 Enrollment ID: I20060126000473 |
| Provider Name | Surendran R Varma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891795316 PECOS PAC ID: 9931168820 Enrollment ID: I20060210000065 |
| Provider Name | Joseph a Babiarz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831109750 PECOS PAC ID: 6103831672 Enrollment ID: I20060221000145 |
| Provider Name | Martha Severino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427016104 PECOS PAC ID: 0446260327 Enrollment ID: I20060424000307 |
| Provider Name | Arjun Banerjee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629021183 PECOS PAC ID: 3173534450 Enrollment ID: I20060530000085 |
| Provider Name | Jawad Haider |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194773564 PECOS PAC ID: 0749292522 Enrollment ID: I20060616000169 |
| Provider Name | Gail Labadia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649202144 PECOS PAC ID: 5991700395 Enrollment ID: I20060918000372 |
| Provider Name | Erica P Colavolpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598860132 PECOS PAC ID: 0840296976 Enrollment ID: I20061013000334 |
| Provider Name | Richard M Shoup |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518930957 PECOS PAC ID: 9133125024 Enrollment ID: I20061017000403 |
| Provider Name | Traci a Friedman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194839506 PECOS PAC ID: 4486651296 Enrollment ID: I20061108000331 |
| Provider Name | David Golden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306954896 PECOS PAC ID: 6305840133 Enrollment ID: I20061219000123 |
| Provider Name | Ellen Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710058144 PECOS PAC ID: 9335140292 Enrollment ID: I20070122000072 |
| Provider Name | David a Klapper |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1346218146 PECOS PAC ID: 8123064169 Enrollment ID: I20070123000459 |
| Provider Name | Victoria R Dauphinais |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871593939 PECOS PAC ID: 1759383656 Enrollment ID: I20070206000326 |
| Provider Name | Lisa Knicos |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1992863799 PECOS PAC ID: 2466454368 Enrollment ID: I20070206000352 |
| Provider Name | Madalina I Raut |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649219064 PECOS PAC ID: 3274512553 Enrollment ID: I20070423000308 |
| Provider Name | Gunjan Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508875089 PECOS PAC ID: 7810991700 Enrollment ID: I20070612000531 |
| Provider Name | Seth M Brown |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1679611701 PECOS PAC ID: 7214038231 Enrollment ID: I20070720000497 |
| Provider Name | Tina Roman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851304869 PECOS PAC ID: 7618078007 Enrollment ID: I20070730000548 |
| Provider Name | Hyoungsup Park |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174512735 PECOS PAC ID: 2062440266 Enrollment ID: I20070817000255 |
| Provider Name | Stephen G Wolfe |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1730245606 PECOS PAC ID: 0042302879 Enrollment ID: I20070823000722 |
| Provider Name | Karl M Dauphinais |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548467897 PECOS PAC ID: 9335231810 Enrollment ID: I20070829000071 |
| Provider Name | Renika N Mcleod-labissiere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578648606 PECOS PAC ID: 0749261642 Enrollment ID: I20071002000569 |
| Provider Name | Jacqueline R Sanz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194842336 PECOS PAC ID: 8224123013 Enrollment ID: I20071009000654 |
| Provider Name | Kevin M Baran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124239728 PECOS PAC ID: 5193811370 Enrollment ID: I20071018000780 |
| Provider Name | Jong Gil Oh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245296573 PECOS PAC ID: 4486630431 Enrollment ID: I20071031000382 |
| Provider Name | Jeffrey Taylor Sievering |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831253517 PECOS PAC ID: 0244320471 Enrollment ID: I20071212000251 |
| Provider Name | Kristine C Lane |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245410422 PECOS PAC ID: 6800976754 Enrollment ID: I20080103000688 |
| Provider Name | Sarah D Matterfis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730238189 PECOS PAC ID: 4688750870 Enrollment ID: I20080328000108 |
| Provider Name | Andrea E Sadowski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013985944 PECOS PAC ID: 4183702475 Enrollment ID: I20080428000439 |
| Provider Name | Craig M Keanna |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881635662 PECOS PAC ID: 6406927003 Enrollment ID: I20080625000014 |
| Provider Name | Mark a Sabo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497954184 PECOS PAC ID: 6103990965 Enrollment ID: I20080729000178 |
| Provider Name | Lindsay S Tarkington |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336306778 PECOS PAC ID: 5991872079 Enrollment ID: I20080916000595 |
| Provider Name | Vivian P Tsuei |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609814987 PECOS PAC ID: 4486549987 Enrollment ID: I20080919000028 |
| Provider Name | Rebecca E Holberg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295926608 PECOS PAC ID: 8820166986 Enrollment ID: I20081003000054 |
| Provider Name | Lynne V Savino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700091774 PECOS PAC ID: 0143389569 Enrollment ID: I20081030000147 |
| Provider Name | Jennifer L Young |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730117938 PECOS PAC ID: 1254326523 Enrollment ID: I20081030000389 |
| Provider Name | Matthew Friedman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437155850 PECOS PAC ID: 5294895553 Enrollment ID: I20081118000035 |
| Provider Name | Margaret Brigham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982615258 PECOS PAC ID: 6507926342 Enrollment ID: I20081124000284 |
| Provider Name | Shilpa Rajashekar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912183187 PECOS PAC ID: 1850452368 Enrollment ID: I20081202000806 |
| Provider Name | Susan M Meissner |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1770579575 PECOS PAC ID: 2264593433 Enrollment ID: I20081205000471 |
| Provider Name | Ivelisse Rivera Godreau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407881626 PECOS PAC ID: 7416955695 Enrollment ID: I20081208000200 |
| Provider Name | Munish K Shastri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649280538 PECOS PAC ID: 5799840575 Enrollment ID: I20090211000016 |
| Provider Name | Heather M Platt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497714539 PECOS PAC ID: 1456418268 Enrollment ID: I20090324000005 |
| Provider Name | Joy a Arico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295938520 PECOS PAC ID: 6800953324 Enrollment ID: I20090326000480 |
| Provider Name | Ernest F Handau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972538676 PECOS PAC ID: 4688694029 Enrollment ID: I20090415000664 |
| Provider Name | Joseph a Newell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508958943 PECOS PAC ID: 8325197163 Enrollment ID: I20090527000266 |
| Provider Name | Jennifer S Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649415977 PECOS PAC ID: 9436209376 Enrollment ID: I20090615000371 |
| Provider Name | Elizabeth J Northrop |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700060068 PECOS PAC ID: 3870645740 Enrollment ID: I20090723000639 |
| Provider Name | Jennifer L Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710145552 PECOS PAC ID: 2668526625 Enrollment ID: I20090811000311 |
| Provider Name | Belachew Tessema |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1417005000 PECOS PAC ID: 9638223381 Enrollment ID: I20090815000119 |
| Provider Name | Dorothy Fojtik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720012727 PECOS PAC ID: 4486649860 Enrollment ID: I20090826000231 |
| Provider Name | Ivette E Diaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134109374 PECOS PAC ID: 1658427562 Enrollment ID: I20090917000629 |
| Provider Name | Maria G De Sousa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548450422 PECOS PAC ID: 1052467826 Enrollment ID: I20090918000551 |
| Provider Name | Ashley M Saunders |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063643369 PECOS PAC ID: 5698811438 Enrollment ID: I20091007000666 |
| Provider Name | Denes Balazs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982610192 PECOS PAC ID: 7911043534 Enrollment ID: I20091012000323 |
| Provider Name | Deedee S Greco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154655751 PECOS PAC ID: 5395882682 Enrollment ID: I20091019000375 |
| Provider Name | Stephanie a Parrillo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598904161 PECOS PAC ID: 1052459237 Enrollment ID: I20091109000271 |
| Provider Name | Steven W Luger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811964752 PECOS PAC ID: 2062551419 Enrollment ID: I20091125000169 |
| Provider Name | Lynn F Firestone |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1992708226 PECOS PAC ID: 8729127071 Enrollment ID: I20091130000617 |
| Provider Name | Michael D Baldwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104895382 PECOS PAC ID: 6800935834 Enrollment ID: I20091203000471 |
| Provider Name | Andrew B Schachter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790798650 PECOS PAC ID: 3274672043 Enrollment ID: I20091208000440 |
| Provider Name | Cheryl Mcdonald |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902816812 PECOS PAC ID: 7911047352 Enrollment ID: I20091216000399 |
| Provider Name | James a Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437162583 PECOS PAC ID: 0244370351 Enrollment ID: I20091222000278 |
| Provider Name | Steven M Curland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609982560 PECOS PAC ID: 1850431966 Enrollment ID: I20091222000313 |
| Provider Name | John Schifferdecker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255344123 PECOS PAC ID: 4183764293 Enrollment ID: I20091222000347 |
| Provider Name | Richard Truex |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568473825 PECOS PAC ID: 8527108638 Enrollment ID: I20091222000365 |
| Provider Name | John F Mullaney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669484929 PECOS PAC ID: 9436299559 Enrollment ID: I20091222000379 |
| Provider Name | David Mintell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366453243 PECOS PAC ID: 8426198540 Enrollment ID: I20091222000386 |
| Provider Name | Stuart Genser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871505313 PECOS PAC ID: 3375683493 Enrollment ID: I20091222000416 |
| Provider Name | Kaitlin F Salkeld |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780918391 PECOS PAC ID: 1759421795 Enrollment ID: I20091222000669 |
| Provider Name | Cheryl Laflamme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760495881 PECOS PAC ID: 7618017690 Enrollment ID: I20091223000270 |
| Provider Name | Herbert J Keating |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588676852 PECOS PAC ID: 3173663168 Enrollment ID: I20091223000357 |
| Provider Name | David S Salm |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184727273 PECOS PAC ID: 5890835888 Enrollment ID: I20091223000365 |
| Provider Name | Stuart E Herlands |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336150309 PECOS PAC ID: 8527964477 Enrollment ID: I20091223000385 |
| Provider Name | Paul M Vella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447263546 PECOS PAC ID: 0941340947 Enrollment ID: I20091223000402 |
| Provider Name | Terrence W Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982617833 PECOS PAC ID: 1153461165 Enrollment ID: I20091223000455 |
| Provider Name | Alla Bernshteyn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063499507 PECOS PAC ID: 6103874516 Enrollment ID: I20091230000317 |
| Provider Name | Rubin W Hirsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225049240 PECOS PAC ID: 1557403490 Enrollment ID: I20100115000183 |
| Provider Name | Timothy J Buckley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558372805 PECOS PAC ID: 4880736727 Enrollment ID: I20100115000219 |
| Provider Name | Michael M Olsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710990817 PECOS PAC ID: 9032251749 Enrollment ID: I20100119000397 |
| Provider Name | Richard G Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861505588 PECOS PAC ID: 0042352767 Enrollment ID: I20100119000479 |
| Provider Name | Geetha Gangu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235102138 PECOS PAC ID: 4789726126 Enrollment ID: I20100122000203 |
| Provider Name | Antonio Scappaticci |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124031075 PECOS PAC ID: 1951444132 Enrollment ID: I20100210000512 |
| Provider Name | Stephen Yoelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306856463 PECOS PAC ID: 6103960968 Enrollment ID: I20100217000094 |
| Provider Name | Rebecca L Randazzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801123849 PECOS PAC ID: 5799820536 Enrollment ID: I20100304000823 |
| Provider Name | Charles J Licata |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538172523 PECOS PAC ID: 1052456365 Enrollment ID: I20100310000788 |
| Provider Name | Joseph J Guardino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295746667 PECOS PAC ID: 1759417165 Enrollment ID: I20100324001043 |
| Provider Name | Zbigniew Woznica |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174536486 PECOS PAC ID: 9335275775 Enrollment ID: I20100325000069 |
| Provider Name | Christopher J MC Dermott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396738076 PECOS PAC ID: 4385770007 Enrollment ID: I20100331001070 |
| Provider Name | Devika R Kasaraneni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366454795 PECOS PAC ID: 9830226117 Enrollment ID: I20100419000119 |
| Provider Name | Carol Weitzman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134102379 PECOS PAC ID: 6002944501 Enrollment ID: I20100504000233 |
| Provider Name | Aliya Shamsi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134224728 PECOS PAC ID: 8628106713 Enrollment ID: I20100511000647 |
| Provider Name | Rita C Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396980314 PECOS PAC ID: 4385772326 Enrollment ID: I20100512000308 |
| Provider Name | Susan S Neagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508099243 PECOS PAC ID: 9739217704 Enrollment ID: I20100512000566 |
| Provider Name | Annette Eppler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518199769 PECOS PAC ID: 0547398554 Enrollment ID: I20100512001016 |
| Provider Name | Elzbieta L Piekarz-dyjak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598864217 PECOS PAC ID: 7618055575 Enrollment ID: I20100519000008 |
| Provider Name | Andrew H Selinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114937141 PECOS PAC ID: 5294864245 Enrollment ID: I20100601000063 |
| Provider Name | Stephen N Grimaldi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831101229 PECOS PAC ID: 2062541071 Enrollment ID: I20100601000768 |
| Provider Name | Elizabeth T Pericat |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154334274 PECOS PAC ID: 7810026648 Enrollment ID: I20100603000427 |
| Provider Name | Karin Michels Ashwood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922072644 PECOS PAC ID: 3476683004 Enrollment ID: I20100609000050 |
| Provider Name | Shiji a Isaac |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528112299 PECOS PAC ID: 5698805018 Enrollment ID: I20100611000159 |
| Provider Name | Nancy H Hurlburt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952313694 PECOS PAC ID: 1355471434 Enrollment ID: I20100616000631 |
| Provider Name | Lea Bailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205847134 PECOS PAC ID: 7012047038 Enrollment ID: I20100617000252 |
| Provider Name | Anthony a Mascia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306856281 PECOS PAC ID: 0345370383 Enrollment ID: I20100617000431 |
| Provider Name | Jonathan Rosen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215940135 PECOS PAC ID: 9537065487 Enrollment ID: I20100621000245 |
| Provider Name | Jeffrey R Goldberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093723983 PECOS PAC ID: 9537299425 Enrollment ID: I20100621000442 |
| Provider Name | Robert W Kyrcz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346253457 PECOS PAC ID: 7517098403 Enrollment ID: I20100621000476 |
| Provider Name | Christopher S Curdo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497766422 PECOS PAC ID: 7416088307 Enrollment ID: I20100621000493 |
| Provider Name | Mario Amleto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447260336 PECOS PAC ID: 5395876288 Enrollment ID: I20100621000538 |
| Provider Name | Elizabeth Solano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275544157 PECOS PAC ID: 7719885391 Enrollment ID: I20100621000550 |
| Provider Name | Benjamin Kahn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255447504 PECOS PAC ID: 3274664164 Enrollment ID: I20100621000574 |
| Provider Name | Stacey T Unsworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023020070 PECOS PAC ID: 8921139718 Enrollment ID: I20100622000877 |
| Provider Name | Samuel K Anyatonwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023028933 PECOS PAC ID: 8921139759 Enrollment ID: I20100623000332 |
| Provider Name | Tatiana K Feld |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083626774 PECOS PAC ID: 2163553918 Enrollment ID: I20100623000656 |
| Provider Name | Carlos R Valentin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366454357 PECOS PAC ID: 8628109493 Enrollment ID: I20100623000891 |
| Provider Name | Penny Mcevoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801806724 PECOS PAC ID: 6002947413 Enrollment ID: I20100629000679 |
| Provider Name | Amor C Lomibao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760495683 PECOS PAC ID: 0941332894 Enrollment ID: I20100713000453 |
| Provider Name | Timothy J Holsbeke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477539906 PECOS PAC ID: 4082746953 Enrollment ID: I20100714000011 |
| Provider Name | Kerline a Vassell-klaus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427134766 PECOS PAC ID: 5294867966 Enrollment ID: I20100715000323 |
| Provider Name | Joshua Fink |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861551145 PECOS PAC ID: 7810029386 Enrollment ID: I20100719000665 |
| Provider Name | Tamar R Braverman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639185093 PECOS PAC ID: 4688706088 Enrollment ID: I20100721000212 |
| Provider Name | Laura J Pickett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306826748 PECOS PAC ID: 8628101300 Enrollment ID: I20100802000410 |
| Provider Name | Stephen Bryant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386655694 PECOS PAC ID: 9032242763 Enrollment ID: I20100802000954 |
| Provider Name | Thomas P Meehan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750301958 PECOS PAC ID: 8921131376 Enrollment ID: I20100805000197 |
| Provider Name | Joy E Hong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669484630 PECOS PAC ID: 1254464597 Enrollment ID: I20100806000208 |
| Provider Name | Daniel R Tardif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538170980 PECOS PAC ID: 6103959465 Enrollment ID: I20100806000413 |
| Provider Name | David Edelheit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558338004 PECOS PAC ID: 0446383657 Enrollment ID: I20100809000149 |
| Provider Name | Fauzia Beig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467659011 PECOS PAC ID: 8527192459 Enrollment ID: I20100814000100 |
| Provider Name | Emily Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710989520 PECOS PAC ID: 3173647013 Enrollment ID: I20100831000004 |
| Provider Name | Robert L Wenick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508820598 PECOS PAC ID: 0143344952 Enrollment ID: I20100831000872 |
| Provider Name | James Finnerty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437154663 PECOS PAC ID: 9436189495 Enrollment ID: I20100831000889 |
| Provider Name | Sean Mcgrade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346205770 PECOS PAC ID: 9931223740 Enrollment ID: I20100831000910 |
| Provider Name | Thomas P Whelan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720043227 PECOS PAC ID: 4385768191 Enrollment ID: I20100831000933 |
| Provider Name | Svetlana Tikhomirova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689631467 PECOS PAC ID: 4183748999 Enrollment ID: I20100831000955 |
| Provider Name | Jeffrey Scott Metzger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558328344 PECOS PAC ID: 3072637883 Enrollment ID: I20100831000971 |
| Provider Name | Martin Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902863798 PECOS PAC ID: 4082605407 Enrollment ID: I20100831000980 |
| Provider Name | Eunice V Mello |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457531048 PECOS PAC ID: 7618905001 Enrollment ID: I20100911000129 |
| Provider Name | Angela Biondi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992959308 PECOS PAC ID: 9436275567 Enrollment ID: I20100927000964 |
| Provider Name | Dimitri Ghecas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174595490 PECOS PAC ID: 3870683709 Enrollment ID: I20100928000495 |
| Provider Name | Michael C Trager |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811961014 PECOS PAC ID: 9638164791 Enrollment ID: I20100928000522 |
| Provider Name | Patricia C Mcivor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821102914 PECOS PAC ID: 2961528799 Enrollment ID: I20100929000464 |
| Provider Name | Serle Mindell Epstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912991175 PECOS PAC ID: 6204938475 Enrollment ID: I20101004000085 |
| Provider Name | Wendy Maki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407991888 PECOS PAC ID: 1759283062 Enrollment ID: I20101008000070 |
| Provider Name | Jennifer Donahue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275647448 PECOS PAC ID: 8820280837 Enrollment ID: I20101008000889 |
| Provider Name | Joyce a Fong-breton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376640672 PECOS PAC ID: 7618981796 Enrollment ID: I20101020001266 |
| Provider Name | David a Pazer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710022264 PECOS PAC ID: 3072415397 Enrollment ID: I20101027000992 |
| Provider Name | Faouzi E Hage |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619096948 PECOS PAC ID: 4587858352 Enrollment ID: I20101105000341 |
| Provider Name | Angelee Carta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093782450 PECOS PAC ID: 2365637113 Enrollment ID: I20101108000029 |
| Provider Name | Bjorn Ringstad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699707448 PECOS PAC ID: 4385606433 Enrollment ID: I20101123000309 |
| Provider Name | Bhavna Sacheti Singh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104048610 PECOS PAC ID: 0244428456 Enrollment ID: I20110103000320 |
| Provider Name | Alex Faustin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346440237 PECOS PAC ID: 4789878968 Enrollment ID: I20110112000654 |
| Provider Name | Bryna L Avenia |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336229269 PECOS PAC ID: 5698954873 Enrollment ID: I20110119001298 |
| Provider Name | Kristen Mccartney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144530197 PECOS PAC ID: 6002096146 Enrollment ID: I20110208000164 |
| Provider Name | Spencer Guy Erman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144206699 PECOS PAC ID: 2668653106 Enrollment ID: I20110216001026 |
| Provider Name | Irsal P Cabahug |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477870756 PECOS PAC ID: 3476734575 Enrollment ID: I20110223000113 |
| Provider Name | Elizabeth G Shinkevich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285942961 PECOS PAC ID: 2961683859 Enrollment ID: I20110225000183 |
| Provider Name | Katherine E Voss |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821129966 PECOS PAC ID: 2466633367 Enrollment ID: I20110225000239 |
| Provider Name | Karen Cadman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437127370 PECOS PAC ID: 8820270689 Enrollment ID: I20110315000879 |
| Provider Name | Sandra Peccerillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932101854 PECOS PAC ID: 7214111046 Enrollment ID: I20110401000885 |
| Provider Name | Bernadette Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215233853 PECOS PAC ID: 2961686266 Enrollment ID: I20110412000175 |
| Provider Name | Derek T Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790954931 PECOS PAC ID: 7416131685 Enrollment ID: I20110413000040 |
| Provider Name | Katherine M Bares |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134376304 PECOS PAC ID: 9234299629 Enrollment ID: I20110426000771 |
| Provider Name | Bonnie Lender |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245560770 PECOS PAC ID: 4688859945 Enrollment ID: I20110502000075 |
| Provider Name | Sharon Kandro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528181716 PECOS PAC ID: 0648455659 Enrollment ID: I20110505000801 |
| Provider Name | Robert E Parnes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740257211 PECOS PAC ID: 4082890793 Enrollment ID: I20110513000515 |
| Provider Name | Margot H Dayton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386829893 PECOS PAC ID: 6204012727 Enrollment ID: I20110518000534 |
| Provider Name | Kerri Ann Fraterrigo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659571750 PECOS PAC ID: 4284810516 Enrollment ID: I20110520000253 |
| Provider Name | Craig W Czarsty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639104680 PECOS PAC ID: 4183800360 Enrollment ID: I20110526000055 |
| Provider Name | Vijai B Muthukrishnan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003016270 PECOS PAC ID: 3678750494 Enrollment ID: I20110603000414 |
| Provider Name | Kathleen Obuchon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245539873 PECOS PAC ID: 3476731076 Enrollment ID: I20110630000342 |
| Provider Name | Benjamin J Wycherly |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1932356508 PECOS PAC ID: 2062695471 Enrollment ID: I20110909002472 |
| Provider Name | Elise Winter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003195785 PECOS PAC ID: 0042481327 Enrollment ID: I20110916000231 |
| Provider Name | Mary Angela Glenn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790845949 PECOS PAC ID: 1456522135 Enrollment ID: I20110929000571 |
| Provider Name | Jessica Palozie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881901742 PECOS PAC ID: 6305018045 Enrollment ID: I20110930000486 |
| Provider Name | Christopher Jon Doan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871754945 PECOS PAC ID: 2961674239 Enrollment ID: I20111010000237 |
| Provider Name | Carol J Fiftal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548331374 PECOS PAC ID: 6901078294 Enrollment ID: I20111010000471 |
| Provider Name | Michael E Blefeld |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104997923 PECOS PAC ID: 4385816529 Enrollment ID: I20111011000638 |
| Provider Name | Heidi M Smolka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124329461 PECOS PAC ID: 7810169091 Enrollment ID: I20111012000283 |
| Provider Name | Gordon L Brodie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114995016 PECOS PAC ID: 8527230663 Enrollment ID: I20111021000546 |
| Provider Name | Ekta Khanna |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154586691 PECOS PAC ID: 9830365899 Enrollment ID: I20111222000407 |
| Provider Name | Bernard a Giserman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467552166 PECOS PAC ID: 4082880968 Enrollment ID: I20111223000058 |
| Provider Name | Sarah Annette Diramio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013147305 PECOS PAC ID: 8527104553 Enrollment ID: I20120109000674 |
| Provider Name | Georgia Sterpka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548537731 PECOS PAC ID: 9032386826 Enrollment ID: I20120119000240 |
| Provider Name | Ellen Beth |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740594282 PECOS PAC ID: 2769675750 Enrollment ID: I20120124000422 |
| Provider Name | Lacy C Birdseye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972872463 PECOS PAC ID: 4981861408 Enrollment ID: I20120210000067 |
| Provider Name | Leah G Wallace |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518233931 PECOS PAC ID: 1759542947 Enrollment ID: I20120416000319 |
| Provider Name | Jessica M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134350432 PECOS PAC ID: 7719026293 Enrollment ID: I20120418000273 |
| Provider Name | Marybeth a Moore |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033389192 PECOS PAC ID: 2466619119 Enrollment ID: I20120426000016 |
| Provider Name | Florence a Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164665774 PECOS PAC ID: 3375706740 Enrollment ID: I20120522001029 |
| Provider Name | Colleen R Chappell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487910527 PECOS PAC ID: 6103081260 Enrollment ID: I20120625000003 |
| Provider Name | William R Mcqueen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376594531 PECOS PAC ID: 9032004544 Enrollment ID: I20120801000000 |
| Provider Name | Sarah Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417043621 PECOS PAC ID: 0446229298 Enrollment ID: I20120810000186 |
| Provider Name | James Ocampo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720221344 PECOS PAC ID: 4385890813 Enrollment ID: I20120815000670 |
| Provider Name | Patricia L Woessner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942562707 PECOS PAC ID: 4183871502 Enrollment ID: I20120820000945 |
| Provider Name | Kasia Koziol Dube |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801024302 PECOS PAC ID: 0547418550 Enrollment ID: I20120918000002 |
| Provider Name | Allyson L Salek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942474739 PECOS PAC ID: 5698816049 Enrollment ID: I20120926000751 |
| Provider Name | Demetra Eleftheriou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104838812 PECOS PAC ID: 3577689843 Enrollment ID: I20121004000669 |
| Provider Name | Aericka Robyn Khongdy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710234448 PECOS PAC ID: 7113177601 Enrollment ID: I20121018000135 |
| Provider Name | Jacquelyne M Phanavong |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730439597 PECOS PAC ID: 3577713015 Enrollment ID: I20121018000659 |
| Provider Name | Antigona M Ajro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942550991 PECOS PAC ID: 0446400873 Enrollment ID: I20121022000190 |
| Provider Name | James R Doran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942249610 PECOS PAC ID: 5698701548 Enrollment ID: I20121113000430 |
| Provider Name | Rosanna Chapleau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073650180 PECOS PAC ID: 6204087414 Enrollment ID: I20121116000501 |
| Provider Name | Jennifer L Clark-connor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083967483 PECOS PAC ID: 3678726460 Enrollment ID: I20130103000054 |
| Provider Name | Lolither R Darling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801149604 PECOS PAC ID: 2062665466 Enrollment ID: I20130116000057 |
| Provider Name | Kayla L Bubier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831442144 PECOS PAC ID: 7416101159 Enrollment ID: I20130206000149 |
| Provider Name | Emily J Tuozzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497004402 PECOS PAC ID: 8527203777 Enrollment ID: I20130318000498 |
| Provider Name | Monique Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932362522 PECOS PAC ID: 4587814116 Enrollment ID: I20130520000639 |
| Provider Name | Alison D Sturm |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316025661 PECOS PAC ID: 2062685381 Enrollment ID: I20130621000002 |
| Provider Name | Brett Nowlan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861688772 PECOS PAC ID: 2860631769 Enrollment ID: I20130626000311 |
| Provider Name | Doralynne R Dipasquale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235429697 PECOS PAC ID: 7416197900 Enrollment ID: I20130705000000 |
| Provider Name | Courtney Whittle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801137039 PECOS PAC ID: 7517108368 Enrollment ID: I20130722000198 |
| Provider Name | Angela Stein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730315458 PECOS PAC ID: 1658513536 Enrollment ID: I20130805000862 |
| Provider Name | Dana E Novak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538417761 PECOS PAC ID: 1355583402 Enrollment ID: I20130820000466 |
| Provider Name | Whitney Showman-boyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366887234 PECOS PAC ID: 7012151897 Enrollment ID: I20130917000509 |
| Provider Name | Jill E Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154574416 PECOS PAC ID: 2860552825 Enrollment ID: I20130920000635 |
| Provider Name | Sarah F Arseneault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235437468 PECOS PAC ID: 6204070659 Enrollment ID: I20130925000140 |
| Provider Name | Thomas H Gorin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942258157 PECOS PAC ID: 0840424644 Enrollment ID: I20131010000692 |
| Provider Name | Tigist D Ashagari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619246667 PECOS PAC ID: 0345474862 Enrollment ID: I20131015002221 |
| Provider Name | Craig R Elliott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275581472 PECOS PAC ID: 5395979793 Enrollment ID: I20131017000693 |
| Provider Name | Simone N Bentley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174872469 PECOS PAC ID: 9436383809 Enrollment ID: I20131018000727 |
| Provider Name | Julia M Toto |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1407018419 PECOS PAC ID: 8426220500 Enrollment ID: I20131024000879 |
| Provider Name | Diana N Striffler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174861702 PECOS PAC ID: 9931334083 Enrollment ID: I20131028001239 |
| Provider Name | Anne Willenborg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801844006 PECOS PAC ID: 3779719471 Enrollment ID: I20131203000759 |
| Provider Name | Alona Kantorovich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780808949 PECOS PAC ID: 9739235961 Enrollment ID: I20140107000014 |
| Provider Name | Jyoti Mittal |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033484241 PECOS PAC ID: 8224287362 Enrollment ID: I20140107000429 |
| Provider Name | Margaret O Omojola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285070854 PECOS PAC ID: 7517195076 Enrollment ID: I20140109000112 |
| Provider Name | Katarzyna Noonan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811207442 PECOS PAC ID: 1153559976 Enrollment ID: I20140124000037 |
| Provider Name | Catherine M Demers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487085593 PECOS PAC ID: 1052540838 Enrollment ID: I20140128001212 |
| Provider Name | Thao T Doran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699865063 PECOS PAC ID: 8729089040 Enrollment ID: I20140130000648 |
| Provider Name | Karen Goldberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457331191 PECOS PAC ID: 0648400531 Enrollment ID: I20140219001877 |
| Provider Name | Bruce Freeman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467432252 PECOS PAC ID: 2264662972 Enrollment ID: I20140225001323 |
| Provider Name | Eileen Lawrence |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427038181 PECOS PAC ID: 8527298264 Enrollment ID: I20140226000183 |
| Provider Name | Rebekah Y Lehtonen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841611563 PECOS PAC ID: 2668602095 Enrollment ID: I20140305000966 |
| Provider Name | Danielle B Alves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295177434 PECOS PAC ID: 8224268404 Enrollment ID: I20140310000313 |
| Provider Name | Edward Lee |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1699940692 PECOS PAC ID: 9032248158 Enrollment ID: I20140417000237 |
| Provider Name | Dottie B Leighton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558795070 PECOS PAC ID: 8123250347 Enrollment ID: I20140422000974 |
| Provider Name | Marie Helene Pouliot |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982780227 PECOS PAC ID: 7517180680 Enrollment ID: I20140516001225 |
| Provider Name | Ryan W Maringola |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376739623 PECOS PAC ID: 1658594114 Enrollment ID: I20140602001214 |
| Provider Name | Laurie Mcanaspie |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619051547 PECOS PAC ID: 0547490807 Enrollment ID: I20140602001946 |
| Provider Name | Carly M Madore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396012498 PECOS PAC ID: 1052536570 Enrollment ID: I20140625001650 |
| Provider Name | Claire M Mcchesney |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1760720817 PECOS PAC ID: 1153546601 Enrollment ID: I20140626000160 |
| Provider Name | Binayak Koirala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548572720 PECOS PAC ID: 1759512064 Enrollment ID: I20140627001324 |
| Provider Name | Monika V Fuller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093023806 PECOS PAC ID: 0547485831 Enrollment ID: I20140630000393 |
| Provider Name | Margaret Gross |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467552588 PECOS PAC ID: 8224254602 Enrollment ID: I20140721000676 |
| Provider Name | Waile Ramadan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083906416 PECOS PAC ID: 0446476790 Enrollment ID: I20140723001656 |
| Provider Name | Lynda M Lombardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992128128 PECOS PAC ID: 7618106550 Enrollment ID: I20140729000930 |
| Provider Name | Vanessa Boccaccio Stockford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558777011 PECOS PAC ID: 1951528728 Enrollment ID: I20140819001275 |
| Provider Name | Jennifer B Mastrocola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972896561 PECOS PAC ID: 9739308131 Enrollment ID: I20140917001644 |
| Provider Name | Alexandra N Schain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578973905 PECOS PAC ID: 1850511973 Enrollment ID: I20141013000523 |
| Provider Name | Tamika L Blackburn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053593079 PECOS PAC ID: 8123184751 Enrollment ID: I20141021000070 |
| Provider Name | Florence Olakojo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457772964 PECOS PAC ID: 1951623156 Enrollment ID: I20141125000486 |
| Provider Name | Chinyere Okoronkwo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861770711 PECOS PAC ID: 1951623727 Enrollment ID: I20141205000316 |
| Provider Name | Cynthia Bodeur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518373398 PECOS PAC ID: 7810210671 Enrollment ID: I20141231000236 |
| Provider Name | Christopher M Desanto |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679530034 PECOS PAC ID: 8729063102 Enrollment ID: I20150105001972 |
| Provider Name | Johanna T Mcdermott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699101188 PECOS PAC ID: 3274760277 Enrollment ID: I20150206001493 |
| Provider Name | Sarah Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003241100 PECOS PAC ID: 2567787740 Enrollment ID: I20150210001509 |
| Provider Name | Stephanie Belanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407108293 PECOS PAC ID: 4587980156 Enrollment ID: I20150226001622 |
| Provider Name | Ryan Roth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225453517 PECOS PAC ID: 2466779871 Enrollment ID: I20150324001485 |
| Provider Name | Patricia L Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417103334 PECOS PAC ID: 7416274774 Enrollment ID: I20150325001147 |
| Provider Name | Evelyne L Deloughery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821420134 PECOS PAC ID: 6800113846 Enrollment ID: I20150331002213 |
| Provider Name | Matthew Sleboda |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578706768 PECOS PAC ID: 4082932298 Enrollment ID: I20150421000221 |
| Provider Name | Kirsten D Grillo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235435835 PECOS PAC ID: 5597949917 Enrollment ID: I20150529002126 |
| Provider Name | Kelly K Greco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700136827 PECOS PAC ID: 0941521991 Enrollment ID: I20150603001148 |
| Provider Name | Tracy Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013144369 PECOS PAC ID: 0648591032 Enrollment ID: I20150611000014 |
| Provider Name | Maria Theresa Santos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821316274 PECOS PAC ID: 8628389350 Enrollment ID: I20150622000807 |
| Provider Name | Marianne D Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457635476 PECOS PAC ID: 7315258860 Enrollment ID: I20150624002184 |
| Provider Name | Ashlee S Doherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750768859 PECOS PAC ID: 3577875517 Enrollment ID: I20150706002048 |
| Provider Name | Rena L Aroesty |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629335062 PECOS PAC ID: 3274853353 Enrollment ID: I20150831001574 |
| Provider Name | Kimberly C Gygi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356600787 PECOS PAC ID: 2365674934 Enrollment ID: I20150904000945 |
| Provider Name | Susan J Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265814719 PECOS PAC ID: 9739495730 Enrollment ID: I20150908000991 |
| Provider Name | Jared D Wasser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528334695 PECOS PAC ID: 2163745241 Enrollment ID: I20150910000237 |
| Provider Name | Melissa a Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679959530 PECOS PAC ID: 1052629433 Enrollment ID: I20151005001855 |
| Provider Name | Kristen M Debisceglie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225435423 PECOS PAC ID: 4688999857 Enrollment ID: I20151013001348 |
| Provider Name | Anthony Guglielmo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700279452 PECOS PAC ID: 6507175346 Enrollment ID: I20151019001697 |
| Provider Name | Anna Russo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184000978 PECOS PAC ID: 8921308974 Enrollment ID: I20151124002235 |
| Provider Name | Natalie Telthorst |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548631344 PECOS PAC ID: 2961702451 Enrollment ID: I20151207000907 |
| Provider Name | Elizabeth C Indorf |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144652348 PECOS PAC ID: 3476783887 Enrollment ID: I20151208002623 |
| Provider Name | Mary C Tran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003001587 PECOS PAC ID: 9234213760 Enrollment ID: I20160121002007 |
| Provider Name | Sarah E Jendza |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104299395 PECOS PAC ID: 5193028231 Enrollment ID: I20160122001001 |
| Provider Name | Fredo J Clermont |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649641150 PECOS PAC ID: 6002112455 Enrollment ID: I20160310000901 |
| Provider Name | Laura H Jaeger |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740412915 PECOS PAC ID: 5496893505 Enrollment ID: I20160323000412 |
| Provider Name | Kimberly H Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851750459 PECOS PAC ID: 4880993211 Enrollment ID: I20160505001811 |
| Provider Name | Siama M Ramlogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386063840 PECOS PAC ID: 4789983446 Enrollment ID: I20160520001330 |
| Provider Name | Samela Brown |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780054056 PECOS PAC ID: 7214227420 Enrollment ID: I20160531002039 |
| Provider Name | Timothy R Rausch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285035303 PECOS PAC ID: 4486945193 Enrollment ID: I20160627001713 |
| Provider Name | Joseph P Brophy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659699460 PECOS PAC ID: 8426226424 Enrollment ID: I20160627001858 |
| Provider Name | Kimberly a Peace |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932408291 PECOS PAC ID: 4688965304 Enrollment ID: I20160627002041 |
| Provider Name | Alana C Rebollo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730567611 PECOS PAC ID: 7911213681 Enrollment ID: I20160629000007 |
| Provider Name | Sherald P Eklund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174654941 PECOS PAC ID: 3476848094 Enrollment ID: I20160822002039 |
| Provider Name | Emmet P Ferriter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497199756 PECOS PAC ID: 9537466206 Enrollment ID: I20160908000742 |
| Provider Name | Kaitlyn M Guardino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184967432 PECOS PAC ID: 8527387117 Enrollment ID: I20161011001103 |
| Provider Name | Rashele P Yarborough |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346505567 PECOS PAC ID: 3678713070 Enrollment ID: I20161025001938 |
| Provider Name | Pranav K Kapoor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972868198 PECOS PAC ID: 5991945388 Enrollment ID: I20161102000045 |
| Provider Name | Margaret T Rush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063777282 PECOS PAC ID: 1153561402 Enrollment ID: I20161102001238 |
| Provider Name | Kelly I Mitchell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477002913 PECOS PAC ID: 2163702226 Enrollment ID: I20161206002247 |
| Provider Name | Kimberley D Rutherford |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174721138 PECOS PAC ID: 6305002940 Enrollment ID: I20161220000640 |
| Provider Name | Holly a Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063956480 PECOS PAC ID: 0749561629 Enrollment ID: I20170109001210 |
| Provider Name | Lindsey E Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265974695 PECOS PAC ID: 5698056570 Enrollment ID: I20170109001449 |
| Provider Name | Julia Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225583214 PECOS PAC ID: 1951682780 Enrollment ID: I20170110000510 |
| Provider Name | Victoria Tofield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760924237 PECOS PAC ID: 2961785852 Enrollment ID: I20170220002820 |
| Provider Name | Shelby a Spazzarini |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093258865 PECOS PAC ID: 2567747546 Enrollment ID: I20170315000862 |
| Provider Name | Ruth G Benet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851711329 PECOS PAC ID: 1850617333 Enrollment ID: I20170501000323 |
| Provider Name | Amy Chai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710399548 PECOS PAC ID: 2466720339 Enrollment ID: I20170616002150 |
| Provider Name | Kristen Lynn Haney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700262409 PECOS PAC ID: 0749587418 Enrollment ID: I20170814001760 |
| Provider Name | Danielle S Phillip-journal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609282219 PECOS PAC ID: 3779880554 Enrollment ID: I20170825000981 |
| Provider Name | Caryn Hannah Cohen Sloate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154842920 PECOS PAC ID: 8224301361 Enrollment ID: I20170912000714 |
| Provider Name | Stephanie Fow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679095129 PECOS PAC ID: 9739454687 Enrollment ID: I20171003007696 |
| Provider Name | Rebecca M Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881118479 PECOS PAC ID: 0042585408 Enrollment ID: I20171011000936 |
| Provider Name | Hailun Wang |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174815096 PECOS PAC ID: 6709176092 Enrollment ID: I20171011001894 |
| Provider Name | Chinelo Okwuosa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033515275 PECOS PAC ID: 1153696455 Enrollment ID: I20171012003008 |
| Provider Name | Manuel A. Orta Cobo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346504941 PECOS PAC ID: 8325272305 Enrollment ID: I20171026002043 |
| Provider Name | Sara Cathleen Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043738768 PECOS PAC ID: 6406113448 Enrollment ID: I20171130000563 |
| Provider Name | Meghan Philips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538687884 PECOS PAC ID: 6406114313 Enrollment ID: I20171226001569 |
| Provider Name | Kristy Poulliot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689183014 PECOS PAC ID: 2466710371 Enrollment ID: I20171226001805 |
| Provider Name | Michelle L Allyn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891205316 PECOS PAC ID: 4385903921 Enrollment ID: I20180105000644 |
| Provider Name | Natesha Bestman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992220958 PECOS PAC ID: 9234498171 Enrollment ID: I20180122002223 |
| Provider Name | Deanna Tocco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760745087 PECOS PAC ID: 0345509071 Enrollment ID: I20180125001413 |
| Provider Name | Joanna Wroblewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285145953 PECOS PAC ID: 9931469905 Enrollment ID: I20180213000103 |
| Provider Name | John W Lindsay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376930586 PECOS PAC ID: 8022383686 Enrollment ID: I20180307000209 |
| Provider Name | Alicia Dodson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396954764 PECOS PAC ID: 2769671908 Enrollment ID: I20180307000486 |
| Provider Name | Kaitlyn Margaret Foley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942680616 PECOS PAC ID: 4880956333 Enrollment ID: I20180320002980 |
| Provider Name | Rachel Glantz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508263617 PECOS PAC ID: 3173807443 Enrollment ID: I20180320003026 |
| Provider Name | Yan Yan Beach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861994220 PECOS PAC ID: 1759643075 Enrollment ID: I20180327001527 |
| Provider Name | Talia Lachcik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730688250 PECOS PAC ID: 2668734831 Enrollment ID: I20180328000790 |
| Provider Name | Aileen Ingal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205035516 PECOS PAC ID: 9133384332 Enrollment ID: I20180605000483 |
| Provider Name | Brenda Edith Chacon - Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285029892 PECOS PAC ID: 5496045148 Enrollment ID: I20180712000307 |
| Provider Name | Isis Sacramento Ferreira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407103997 PECOS PAC ID: 4082933403 Enrollment ID: I20180829000977 |
| Provider Name | Eileen Lonegan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265928154 PECOS PAC ID: 6901156157 Enrollment ID: I20180910000176 |
| Provider Name | Evan S Levine |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366488538 PECOS PAC ID: 7214903830 Enrollment ID: I20180913001293 |
| Provider Name | Tessa Marie Smolinski |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1275027302 PECOS PAC ID: 6709137011 Enrollment ID: I20180926001793 |
| Provider Name | Melissa a Fazzolari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477041564 PECOS PAC ID: 6901157155 Enrollment ID: I20180926003765 |
| Provider Name | Timothy W Chapados |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295112761 PECOS PAC ID: 1951601780 Enrollment ID: I20180927002682 |
| Provider Name | Andrea G. Dixon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699725929 PECOS PAC ID: 6507878329 Enrollment ID: I20181003000092 |
| Provider Name | Jeffrey Larson Goodsell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003296914 PECOS PAC ID: 7012220213 Enrollment ID: I20181003001644 |
| Provider Name | Mary Elizabeth Van Siclen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730590860 PECOS PAC ID: 5092033597 Enrollment ID: I20181003002665 |
| Provider Name | Jessica Weyman Tutolo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811381726 PECOS PAC ID: 9830405430 Enrollment ID: I20181004001431 |
| Provider Name | Tristin Elizabeth Geist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174066674 PECOS PAC ID: 7315299054 Enrollment ID: I20181009000504 |
| Provider Name | Devorah Donnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093196941 PECOS PAC ID: 4789988577 Enrollment ID: I20181011001817 |
| Provider Name | Monali Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942612114 PECOS PAC ID: 5890910996 Enrollment ID: I20181029001206 |
| Provider Name | Caitlin Marie Minihan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265923288 PECOS PAC ID: 7719230267 Enrollment ID: I20181030001978 |
| Provider Name | Nina Erlanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528534641 PECOS PAC ID: 3971857640 Enrollment ID: I20181115001176 |
| Provider Name | Lina M Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235606443 PECOS PAC ID: 9032463336 Enrollment ID: I20181126000441 |
| Provider Name | Ashish Malhotra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750589883 PECOS PAC ID: 5496845844 Enrollment ID: I20181126001746 |
| Provider Name | Theresa M. Keddy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699019281 PECOS PAC ID: 6204172778 Enrollment ID: I20190104001560 |
| Provider Name | Stephen Kivlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982172771 PECOS PAC ID: 7517203565 Enrollment ID: I20190111000575 |
| Provider Name | Davi-ann Francis Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245709864 PECOS PAC ID: 8729324793 Enrollment ID: I20190111001265 |
| Provider Name | Sandra Purcell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770066961 PECOS PAC ID: 2769729763 Enrollment ID: I20190129003309 |
| Provider Name | Kerin Nagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801366646 PECOS PAC ID: 7012254030 Enrollment ID: I20190130000215 |
| Provider Name | Kishore Kumar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760769095 PECOS PAC ID: 1951623925 Enrollment ID: I20190306001804 |
| Provider Name | Joanna Sawicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295299592 PECOS PAC ID: 7315288198 Enrollment ID: I20190403002778 |
| Provider Name | Teresa Domack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235540386 PECOS PAC ID: 6204050412 Enrollment ID: I20190405000728 |
| Provider Name | Rachel Denise Arcila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386115806 PECOS PAC ID: 8123361649 Enrollment ID: I20190523001377 |
| Provider Name | Matthew R Kurimai |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538475496 PECOS PAC ID: 2961745302 Enrollment ID: I20190528001588 |
| Provider Name | Kelly Vanessa Ruiz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831758366 PECOS PAC ID: 3971837857 Enrollment ID: I20190626002601 |
| Provider Name | Alexander Joseph Zorn |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1225697907 PECOS PAC ID: 8224363429 Enrollment ID: I20190710002582 |
| Provider Name | Katy L Fiano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518529882 PECOS PAC ID: 9638405657 Enrollment ID: I20190730001128 |
| Provider Name | Patrick Thomas Ogurick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790104883 PECOS PAC ID: 1557636859 Enrollment ID: I20190730002357 |
| Provider Name | Danielle O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013562784 PECOS PAC ID: 4385974872 Enrollment ID: I20190926000271 |
| Provider Name | Shruti Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558773531 PECOS PAC ID: 8820214083 Enrollment ID: I20191016000298 |
| Provider Name | Amy Kolaczenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699320937 PECOS PAC ID: 8628300183 Enrollment ID: I20191101001687 |
| Provider Name | Onyinyechukwu Kanu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528421807 PECOS PAC ID: 0143514059 Enrollment ID: I20191112000820 |
| Provider Name | Patrene Rhoden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750924429 PECOS PAC ID: 7214369909 Enrollment ID: I20191119000517 |
| Provider Name | Sara Frances Kirsch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952956211 PECOS PAC ID: 7113350422 Enrollment ID: I20191127000567 |
| Provider Name | Adrienne T Lofton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124663653 PECOS PAC ID: 8426481029 Enrollment ID: I20191212002541 |
| Provider Name | Kathleen Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528557857 PECOS PAC ID: 9638503410 Enrollment ID: I20200103000292 |
| Provider Name | Batel Heather Isenstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023374667 PECOS PAC ID: 1658676119 Enrollment ID: I20200117000920 |
| Provider Name | Oksana Roytburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699317412 PECOS PAC ID: 6507291556 Enrollment ID: I20200121001587 |
| Provider Name | Janice Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548822000 PECOS PAC ID: 4284060526 Enrollment ID: I20200205002681 |
| Provider Name | Christie C Marcus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558901512 PECOS PAC ID: 6002243318 Enrollment ID: I20200226002654 |
| Provider Name | Alanna Coughlin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942362652 PECOS PAC ID: 6608204938 Enrollment ID: I20200319000621 |
| Provider Name | Ann Jennings Maley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447471859 PECOS PAC ID: 3375971658 Enrollment ID: I20200319002739 |
| Provider Name | Evelyn Kumah Danso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285276352 PECOS PAC ID: 3971933540 Enrollment ID: I20200422001443 |
| Provider Name | Jonathan Eric Harwin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376692160 PECOS PAC ID: 3476974643 Enrollment ID: I20200527001190 |
| Provider Name | Kerra Maurer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649656414 PECOS PAC ID: 7113236654 Enrollment ID: I20200602000046 |
| Provider Name | Jennifer M Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134251689 PECOS PAC ID: 7517388952 Enrollment ID: I20200610002659 |
| Provider Name | Emily Zheng |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134506892 PECOS PAC ID: 0143646497 Enrollment ID: I20200817003013 |
| Provider Name | Amanda Catherine Ehresman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689297418 PECOS PAC ID: 1759709751 Enrollment ID: I20200908001544 |
| Provider Name | Megan S Afeltra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619593928 PECOS PAC ID: 7214355932 Enrollment ID: I20200912000037 |
| Provider Name | Preston Briggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871110114 PECOS PAC ID: 9032537758 Enrollment ID: I20200912000040 |
| Provider Name | Cristina Boisvert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285258673 PECOS PAC ID: 0244658771 Enrollment ID: I20200916000665 |
| Provider Name | Alexander M Baaklini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194256503 PECOS PAC ID: 9133491251 Enrollment ID: I20201020001571 |
| Provider Name | Jamie Lyn Schned |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669820007 PECOS PAC ID: 3678855921 Enrollment ID: I20201027002091 |
| Provider Name | Yalitza Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780163584 PECOS PAC ID: 2567701501 Enrollment ID: I20201109003177 |
| Provider Name | Nnennaya Duke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992144190 PECOS PAC ID: 9638458219 Enrollment ID: I20201110002015 |
| Provider Name | Maria Haslip |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942829015 PECOS PAC ID: 6800206236 Enrollment ID: I20201113000348 |
| Provider Name | Julianne Belsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598148710 PECOS PAC ID: 9537570619 Enrollment ID: I20201120000886 |
| Provider Name | Elizabeth Chasse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881004828 PECOS PAC ID: 2567751829 Enrollment ID: I20201124002408 |
| Provider Name | Meredith R Halsey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619389541 PECOS PAC ID: 6709003387 Enrollment ID: I20201126000002 |
| Provider Name | Allison Abbott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962741348 PECOS PAC ID: 9436395449 Enrollment ID: I20201213000014 |
| Provider Name | Stephanie D Plasse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659924827 PECOS PAC ID: 8527395599 Enrollment ID: I20210122000098 |
| Provider Name | Elizabeth Solan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942347224 PECOS PAC ID: 8921196783 Enrollment ID: I20210211000860 |
| Provider Name | Julie Mcdermott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609814565 PECOS PAC ID: 7517969900 Enrollment ID: I20210225002087 |
| Provider Name | Ashley Marie Mcmanus |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053901173 PECOS PAC ID: 6709291685 Enrollment ID: I20210301000232 |
| Provider Name | Nicholas Tsamparlis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164515383 PECOS PAC ID: 4385667765 Enrollment ID: I20210302000111 |
| Provider Name | Celinez M Coons |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912474024 PECOS PAC ID: 7911313978 Enrollment ID: I20210317001190 |
| Provider Name | Amanda Shelby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982204715 PECOS PAC ID: 4688083678 Enrollment ID: I20210504000164 |
| Provider Name | Matthew Desir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437531886 PECOS PAC ID: 0042514333 Enrollment ID: I20210507001206 |
| Provider Name | Ingrid Teixeira Furchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215512264 PECOS PAC ID: 2365841699 Enrollment ID: I20210519000078 |
| Provider Name | Danielle Langer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043822794 PECOS PAC ID: 9335549732 Enrollment ID: I20210607000732 |
| Provider Name | Andrea Lynn Delaire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669082830 PECOS PAC ID: 6901206226 Enrollment ID: I20210608002444 |
| Provider Name | Jennifer Pons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043890890 PECOS PAC ID: 9133529183 Enrollment ID: I20210611001648 |
| Provider Name | Tran Ngoc Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033616925 PECOS PAC ID: 5890190219 Enrollment ID: I20210824001777 |
| Provider Name | Shanaaz Shameen Mohammed |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1245426626 PECOS PAC ID: 9032362660 Enrollment ID: I20211014000300 |
| Provider Name | Barbara Wadzanayi Hama |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245708676 PECOS PAC ID: 3072911478 Enrollment ID: I20211015001835 |
| Provider Name | Courtney Souza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457739583 PECOS PAC ID: 8123432887 Enrollment ID: I20220215001323 |
| Provider Name | Vuong Duc Dang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043964570 PECOS PAC ID: 0840679585 Enrollment ID: I20220627000920 |
| Provider Name | Rory Slattery |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356097380 PECOS PAC ID: 4183003882 Enrollment ID: I20220627003508 |
| Provider Name | Anne Machuga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700475829 PECOS PAC ID: 0941689533 Enrollment ID: I20220628003115 |
| Provider Name | Eugenia Golda Volkin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639565195 PECOS PAC ID: 4789064353 Enrollment ID: I20220629002581 |
| Provider Name | Evan Perez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659021699 PECOS PAC ID: 2567843279 Enrollment ID: I20220713000071 |
| Provider Name | Biancha Louise Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932863636 PECOS PAC ID: 1153702659 Enrollment ID: I20220714002827 |
| Provider Name | Brent Faherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902565625 PECOS PAC ID: 9931581634 Enrollment ID: I20220727003064 |
| Provider Name | Nishi Desai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669101259 PECOS PAC ID: 8123401007 Enrollment ID: I20220810003571 |
| Provider Name | Ryan P Drake |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1134651318 PECOS PAC ID: 7719259324 Enrollment ID: I20220817003556 |
| Provider Name | Alyssa Phillips |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811622533 PECOS PAC ID: 2466838115 Enrollment ID: I20221003002849 |
| Provider Name | Quazi Islam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023111879 PECOS PAC ID: 5890742605 Enrollment ID: I20221005001464 |
| Provider Name | Fatema Islam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265538516 PECOS PAC ID: 7416974431 Enrollment ID: I20221013002726 |
| Provider Name | Rachael Marcano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861146003 PECOS PAC ID: 3274900675 Enrollment ID: I20221027000969 |
| Provider Name | Yamini Chalikonda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801459532 PECOS PAC ID: 6800263062 Enrollment ID: I20221101003338 |
| Provider Name | Yevgeniy Borshchenko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932586765 PECOS PAC ID: 9234530536 Enrollment ID: I20221213000084 |
| Provider Name | Anne Fern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649988197 PECOS PAC ID: 9739559089 Enrollment ID: I20221230001436 |
| Provider Name | Delvyann Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285373266 PECOS PAC ID: 5597136374 Enrollment ID: I20230116000493 |
| Provider Name | Sarah Levine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831665686 PECOS PAC ID: 1254670177 Enrollment ID: I20230118000497 |
| Provider Name | Crystal Steed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730616749 PECOS PAC ID: 3274871322 Enrollment ID: I20230220002357 |
| Provider Name | Tricia T Rickettsfacey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619308475 PECOS PAC ID: 3678946647 Enrollment ID: I20230222003138 |
| Provider Name | James Mullen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386189223 PECOS PAC ID: 6800164237 Enrollment ID: I20230301000106 |
| Provider Name | Melissa Purisima Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801592936 PECOS PAC ID: 2769855360 Enrollment ID: I20230301002482 |
| Provider Name | Jack Marshall Stark |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669436820 PECOS PAC ID: 4082850672 Enrollment ID: I20230324000278 |
| Provider Name | Jennifer Rey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134836802 PECOS PAC ID: 6800260266 Enrollment ID: I20230327000380 |
| Provider Name | Samar Hazzan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952458929 PECOS PAC ID: 4981632304 Enrollment ID: I20230602002521 |
| Provider Name | Megan Woodruff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982301545 PECOS PAC ID: 2163889213 Enrollment ID: I20230605001062 |
| Provider Name | Kathryn J. Dugger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396027249 PECOS PAC ID: 6901129220 Enrollment ID: I20230616002657 |
| Provider Name | Itoro Joseph Etim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184334633 PECOS PAC ID: 8729446539 Enrollment ID: I20230626002418 |
| Provider Name | Zainab Sanaa Shajahan Moidu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144881574 PECOS PAC ID: 4284095191 Enrollment ID: I20230725001602 |
| Provider Name | Kaitlin C Quallen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841856879 PECOS PAC ID: 6103151600 Enrollment ID: I20230727001941 |
| Provider Name | Rachel Gilbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063974020 PECOS PAC ID: 8224367362 Enrollment ID: I20230824002757 |
| Provider Name | Sarah Colberg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689366510 PECOS PAC ID: 6103289053 Enrollment ID: I20230825001281 |
| Provider Name | Madison Alaia Fucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164107421 PECOS PAC ID: 1254795024 Enrollment ID: I20230912002697 |
| Provider Name | Sheenay Kendra Pryce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134740467 PECOS PAC ID: 7719331909 Enrollment ID: I20230921001504 |
| Provider Name | Chandel Marie Bouthot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821774068 PECOS PAC ID: 4880040849 Enrollment ID: I20231026002982 |
| Provider Name | Alisa Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588340079 PECOS PAC ID: 6204283609 Enrollment ID: I20231107001265 |
| Provider Name | Collette Martin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205611431 PECOS PAC ID: 1153776422 Enrollment ID: I20231116000366 |
| Provider Name | Suanne Samardge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083495378 PECOS PAC ID: 6305294877 Enrollment ID: I20231121002857 |
| Provider Name | Alexandra Elizabeth Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619668910 PECOS PAC ID: 3678924719 Enrollment ID: I20240112002299 |
| Provider Name | Santiago Sanchez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558037424 PECOS PAC ID: 8729477179 Enrollment ID: I20240209003778 |
| Provider Name | Amelia Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033991674 PECOS PAC ID: 7113360587 Enrollment ID: I20240213002574 |
| Provider Name | Amin R Elashker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093794182 PECOS PAC ID: 8224011390 Enrollment ID: I20240314001648 |
| Provider Name | Marissa Jean Tanasi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285490789 PECOS PAC ID: 5193161925 Enrollment ID: I20240314002141 |
| Provider Name | Jennifer Marie Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063283174 PECOS PAC ID: 2769829415 Enrollment ID: I20240318002253 |
| Provider Name | Kevin Knowlton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598526766 PECOS PAC ID: 6002254018 Enrollment ID: I20240409003697 |
| Provider Name | Priti B Vyas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508964552 PECOS PAC ID: 5395841167 Enrollment ID: I20240509001585 |
| Provider Name | Glendo Tangarorang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134101306 PECOS PAC ID: 4082694088 Enrollment ID: I20240723000275 |
| Provider Name | Jonathan Dodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245099175 PECOS PAC ID: 2264979400 Enrollment ID: I20240805003905 |
| Provider Name | Kenia Gondek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912596602 PECOS PAC ID: 8123412707 Enrollment ID: I20240806000418 |
| Provider Name | Mary Wattick Sutterfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487402301 PECOS PAC ID: 4082152848 Enrollment ID: I20240813000101 |
| Provider Name | Maritza Jasmine Jerome |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649526674 PECOS PAC ID: 6901040559 Enrollment ID: I20240814001701 |
| Provider Name | Stephanie Foster |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134706690 PECOS PAC ID: 4082152699 Enrollment ID: I20240814002146 |
| Provider Name | Mikayla Colleen Surina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285471607 PECOS PAC ID: 3375081581 Enrollment ID: I20240820000886 |
| Provider Name | Pamela C Carrington-tribble |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174544027 PECOS PAC ID: 5799688420 Enrollment ID: I20240927002619 |
| Provider Name | Ashleigh Wells |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417536863 PECOS PAC ID: 7911438841 Enrollment ID: I20241003000362 |
| Provider Name | Sarah Wyka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821653379 PECOS PAC ID: 8022444215 Enrollment ID: I20241003000482 |
| Provider Name | Eugenia Ettlin Loverde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245989300 PECOS PAC ID: 9335673417 Enrollment ID: I20241112002659 |
| Provider Name | Anna Augustin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407343528 PECOS PAC ID: 5294131231 Enrollment ID: I20241113001843 |
| Provider Name | Arikana C. Chihombori |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578557690 PECOS PAC ID: 3779547575 Enrollment ID: I20241114001769 |
| Provider Name | Silvia Stephanie Brescia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730910431 PECOS PAC ID: 6406382266 Enrollment ID: I20241204001673 |
| Provider Name | Jeanne-elyse Gray Cedeno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184867202 PECOS PAC ID: 9537347885 Enrollment ID: I20241204003695 |
| Provider Name | Ling Fang Guo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164059317 PECOS PAC ID: 0648672410 Enrollment ID: I20241205000614 |
| Provider Name | Crisannys Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225864309 PECOS PAC ID: 6406383025 Enrollment ID: I20241220001264 |
| Provider Name | Rebecca Anne Sopelak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396568838 PECOS PAC ID: 4082142393 Enrollment ID: I20250115000821 |
| Provider Name | Jeelu Susan George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598588725 PECOS PAC ID: 6204366560 Enrollment ID: I20250217000545 |
| Provider Name | Ok Hee Rhee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992158364 PECOS PAC ID: 6507194636 Enrollment ID: I20250217000559 |
| Provider Name | Mary Magner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366903510 PECOS PAC ID: 8325416951 Enrollment ID: I20250219000732 |
| Provider Name | Raymond Charles Seligson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578644936 PECOS PAC ID: 2860913233 Enrollment ID: I20250303001212 |
| Provider Name | Kevin Frederick Strong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063432870 PECOS PAC ID: 4385817543 Enrollment ID: I20250314001766 |
| Provider Name | Jasmine A. Cherian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417004219 PECOS PAC ID: 6800912049 Enrollment ID: I20250321001673 |
| Provider Name | Madelaine Rose Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730801549 PECOS PAC ID: 7214450618 Enrollment ID: I20250326002514 |
| Provider Name | Lydia Molnar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235965104 PECOS PAC ID: 3870016850 Enrollment ID: I20250331002627 |
| Provider Name | Kayla Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104629583 PECOS PAC ID: 4082138169 Enrollment ID: I20250410000980 |
| Provider Name | Daniel Jay Roth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467541078 PECOS PAC ID: 7911068473 Enrollment ID: I20250515002382 |
| Provider Name | Jay Kris Pascual |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700917952 PECOS PAC ID: 3577461102 Enrollment ID: I20250610000375 |
| Provider Name | Julie Marie Huston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366246910 PECOS PAC ID: 9133630700 Enrollment ID: I20250619001757 |
| Provider Name | Stephanie Pineiro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154111714 PECOS PAC ID: 1951816065 Enrollment ID: I20250716002352 |
| Provider Name | Erin Dwyer Wendt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588156947 PECOS PAC ID: 3375968886 Enrollment ID: I20250716002467 |
| Provider Name | Andrew Van Scoyk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972165918 PECOS PAC ID: 4183959323 Enrollment ID: I20250717000165 |
| Provider Name | Kevin Carr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366556292 PECOS PAC ID: 9638131923 Enrollment ID: I20250820001056 |
| Provider Name | Jenna Sugar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538800842 PECOS PAC ID: 3779087168 Enrollment ID: I20250918002637 |
| Provider Name | Brittany Addison Bayne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134992829 PECOS PAC ID: 2264936665 Enrollment ID: I20250918002838 |
| Provider Name | John Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326835513 PECOS PAC ID: 3971007212 Enrollment ID: I20250918003320 |
| Provider Name | Alanna Julien Sam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467193268 PECOS PAC ID: 0244734598 Enrollment ID: I20250918003605 |
| Provider Name | Walter E Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619944600 PECOS PAC ID: 5395658736 Enrollment ID: I20250923000290 |
| Provider Name | Shayna Schor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164165593 PECOS PAC ID: 3971985904 Enrollment ID: I20250923001904 |
| Provider Name | Shuja Haider Kazmi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578206710 PECOS PAC ID: 0941676282 Enrollment ID: I20250925003842 |
| Provider Name | Robert George Herman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902867351 PECOS PAC ID: 0749189074 Enrollment ID: I20250930001019 |
| Provider Name | Hadeer Saleh Eltahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023756590 PECOS PAC ID: 2860998788 Enrollment ID: I20250930003891 |
| Provider Name | Shammi K Bali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578556486 PECOS PAC ID: 3072599612 Enrollment ID: I20251002000304 |
| Provider Name | Samantha Robin Avery |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215178090 PECOS PAC ID: 0143443697 Enrollment ID: I20251002004310 |
| Provider Name | Robert Piotrowski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134382898 PECOS PAC ID: 0547442212 Enrollment ID: I20251007003015 |
| Provider Name | Ju Won Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699561159 PECOS PAC ID: 4183112741 Enrollment ID: I20251024001082 |
| Provider Name | Mckenna Tierney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023758752 PECOS PAC ID: 9830689348 Enrollment ID: I20251104001467 |
| Provider Name | Daniel Grossman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891379129 PECOS PAC ID: 8921482423 Enrollment ID: I20251105002115 |
| Provider Name | Kayla Potter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932992427 PECOS PAC ID: 4981195674 Enrollment ID: I20251111000798 |
| Provider Name | Sonal Agarwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851033633 PECOS PAC ID: 4284125873 Enrollment ID: I20251111003587 |
| Provider Name | Aidan Hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790659795 PECOS PAC ID: 7416448451 Enrollment ID: I20251118000847 |
| Provider Name | Zozan Chweich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013411263 PECOS PAC ID: 5991049090 Enrollment ID: I20251121004153 |
| Provider Name | Swaminatha Gurudevan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265525174 PECOS PAC ID: 5294779021 Enrollment ID: I20251126002700 |
| Provider Name | Tina M Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063882538 PECOS PAC ID: 8224318290 Enrollment ID: I20251204003116 |
| Provider Name | Conor Senecal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194104398 PECOS PAC ID: 3678885514 Enrollment ID: I20251209001501 |
| Provider Name | David Song Ko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356720049 PECOS PAC ID: 4688975485 Enrollment ID: I20251215001874 |
| Provider Name | Robin Elizabeth Spence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245410836 PECOS PAC ID: 8224263660 Enrollment ID: I20251215002319 |
State of Connecitut Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 263 Farmington Ave, Infectious Diseases Associates, Farmington, CT 06030 Phone: 860-679-4225 Fax: 860-679-1217 |
Holistic Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1051 Farmington Ave, Farmington, CT 06032 Phone: 860-940-0900 Fax: 860-253-2898 |
Endocrinology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 263 Farmington Ave, Endrocrinology Associates, Farmington, CT 06030 Phone: 860-679-3242 Fax: 860-679-1867 |
Ihpc Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 High St, Farmington, CT 06032 Phone: 860-424-2450 |
Gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 263 Farmington Ave, Gastroenterology Associates, Farmington, CT 06030 Phone: 860-679-7503 Fax: 860-679-1610 |
Claim Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 76 Batterson Park Rd Ste 106, Farmington, CT 06032 Phone: 203-910-7533 |