| Py Medical Services of Ga PC | |
|
3051 Whiteside Rd Macon GA 31216-6209 | |
| (718) 709-0940 | |
| Not Available |
| Full Name | Py Medical Services of Ga PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3051 Whiteside Rd, Macon, Georgia |
| Authorized Official Name and Position | Peyman Younesi (OWNER) |
| Authorized Official Contact | 7187090940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Py Medical Services of Ga PC 6136 170th St Apt M4 Fresh Meadows NY 11365-1957 Ph: (718) 709-0940 | Py Medical Services of Ga PC 3051 Whiteside Rd Macon GA 31216-6209 Ph: (718) 709-0940 |
| NPI Number | 1790541647 |
|---|---|
| Provider Enumeration Date | 02/27/2024 |
| Last Update Date | 10/14/2024 |
| Certification Date | 10/14/2024 |
| Medicare PECOS PAC ID | 7315487709 |
|---|---|
| Medicare Enrollment ID | O20240912000645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790541647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Vicky E Mack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134592033 PECOS PAC ID: 4880988237 Enrollment ID: I20160808000571 |
| Provider Name | Veronica S Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235645037 PECOS PAC ID: 0345597514 Enrollment ID: I20180718003347 |
| Provider Name | Shantrice Bernice Nichols-bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245603844 PECOS PAC ID: 9335449933 Enrollment ID: I20210407000365 |
| Provider Name | Jennifer Nwangburuka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730653122 PECOS PAC ID: 3971858697 Enrollment ID: I20231205001775 |
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