| Siraj Healthcare Incorporated | |
|
3876 Turkeyfoot Rd Elsmere KY 41018-2838 | |
| (859) 342-4087 | |
| Not Available |
| Full Name | Siraj Healthcare Incorporated |
|---|---|
| Speciality | Family Medicine |
| Location | 3876 Turkeyfoot Rd, Elsmere, Kentucky |
| Authorized Official Name and Position | Mohammad Fattal (OWNER) |
| Authorized Official Contact | 8593424087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Siraj Healthcare Incorporated Po Box 6716 Florence KY 41022-6716 Ph: (859) 342-4087 | Siraj Healthcare Incorporated 3876 Turkeyfoot Rd Elsmere KY 41018-2838 Ph: (859) 342-4087 |
| NPI Number | 1487092334 |
|---|---|
| Provider Enumeration Date | 06/12/2013 |
| Last Update Date | 01/08/2024 |
| Medicare PECOS PAC ID | 4981846318 |
|---|---|
| Medicare Enrollment ID | O20130814000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487092334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Ahmad Anjak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033158688 PECOS PAC ID: 0840253977 Enrollment ID: I20050923000766 |
| Provider Name | Mohammad Fattal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114194156 PECOS PAC ID: 5193913796 Enrollment ID: I20101227000230 |
| Provider Name | Teena Marie Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144794942 PECOS PAC ID: 5496093031 Enrollment ID: I20191022002122 |
| Provider Name | Ashley Nicole Pope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063047975 PECOS PAC ID: 8224467527 Enrollment ID: I20200408001596 |
| Provider Name | Candace C. Mckenna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104852144 PECOS PAC ID: 7719172519 Enrollment ID: I20230329002431 |