| Smg Hawthorn | |
|
535 Faunce Corner Rd Dartmouth MA 02747-1242 | |
| (617) 419-4700 | |
| Not Available |
| Full Name | Smg Hawthorn |
|---|---|
| Speciality | Internal Medicine |
| Location | 535 Faunce Corner Rd, Dartmouth, Massachusetts |
| Authorized Official Name and Position | Michael Callum (SMG CEO) |
| Authorized Official Contact | 6174194702 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smg Hawthorn Po Box 12166 Belfast ME 04915-4012 Ph: () - | Smg Hawthorn 535 Faunce Corner Rd Dartmouth MA 02747-1242 Ph: (617) 419-4700 |
| NPI Number | 1821349317 |
|---|---|
| Provider Enumeration Date | 09/25/2012 |
| Last Update Date | 10/31/2023 |
| Medicare PECOS PAC ID | 2860688728 |
|---|---|
| Medicare Enrollment ID | O20130626000396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821349317 | NPI | - | NPPES |
| Provider Name | Michael A Hait |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1326028085 PECOS PAC ID: 7517871924 Enrollment ID: I20031118000978 |
| Provider Name | Steven H Oh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033161385 PECOS PAC ID: 5395641146 Enrollment ID: I20031211000367 |
| Provider Name | Donald M Greenstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235181587 PECOS PAC ID: 1254237027 Enrollment ID: I20031211000456 |
| Provider Name | John Stamoulis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861441891 PECOS PAC ID: 9537060546 Enrollment ID: I20040114000113 |
| Provider Name | Derek A Hausladen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1730195074 PECOS PAC ID: 8628970993 Enrollment ID: I20040126000815 |
| Provider Name | Inna E. Goldberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780775403 PECOS PAC ID: 1658274915 Enrollment ID: I20040202000743 |
| Provider Name | Brian L Coolbaugh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710094396 PECOS PAC ID: 9133112048 Enrollment ID: I20040406001471 |
| Provider Name | Daryl R Parker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366435760 PECOS PAC ID: 9830182609 Enrollment ID: I20040407000064 |
| Provider Name | Susan Stafford |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649221862 PECOS PAC ID: 3678564465 Enrollment ID: I20040520000776 |
| Provider Name | Mary Bakalos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629036090 PECOS PAC ID: 9032190640 Enrollment ID: I20040528000741 |
| Provider Name | Deborah D Fraine |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043224371 PECOS PAC ID: 2163404336 Enrollment ID: I20040602000598 |
| Provider Name | June A Rodrigues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821065913 PECOS PAC ID: 0446232532 Enrollment ID: I20040602001509 |
| Provider Name | Joseph Marc Fonte |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497735229 PECOS PAC ID: 1759363773 Enrollment ID: I20040603000770 |
| Provider Name | Tiegang Ding |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508827429 PECOS PAC ID: 3476536889 Enrollment ID: I20040608000724 |
| Provider Name | Anne Ruggieri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699707901 PECOS PAC ID: 5698759157 Enrollment ID: I20040614001384 |
| Provider Name | Stephen H Karshbaum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124032271 PECOS PAC ID: 2769466853 Enrollment ID: I20040616000492 |
| Provider Name | Slawomir J Pajak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235105206 PECOS PAC ID: 7517941636 Enrollment ID: I20040616000642 |
| Provider Name | Nazli Erbay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083713697 PECOS PAC ID: 0749267102 Enrollment ID: I20040702000562 |
| Provider Name | Hirschel David Mcginnis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881676963 PECOS PAC ID: 0042298556 Enrollment ID: I20040712000296 |
| Provider Name | Sanjay Mudigonda |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942277983 PECOS PAC ID: 7618947946 Enrollment ID: I20040726001332 |
| Provider Name | Thomas M Vallone |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194793513 PECOS PAC ID: 6204806490 Enrollment ID: I20040727000369 |
| Provider Name | Michael F Mastromatteo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023002045 PECOS PAC ID: 7719951482 Enrollment ID: I20040819001602 |
| Provider Name | Hugo G Jauregui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124084611 PECOS PAC ID: 4082688015 Enrollment ID: I20040824001281 |
| Provider Name | Russell P Maling |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528040607 PECOS PAC ID: 0446228845 Enrollment ID: I20040923000316 |
| Provider Name | Elaine Wu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821064874 PECOS PAC ID: 3577531896 Enrollment ID: I20040923000522 |
| Provider Name | Rodrick A Williams |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427096213 PECOS PAC ID: 4880653963 Enrollment ID: I20041005000613 |
| Provider Name | Carol A Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457395972 PECOS PAC ID: 5395709281 Enrollment ID: I20041119000422 |
| Provider Name | Ajay K Singh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215927579 PECOS PAC ID: 4880659689 Enrollment ID: I20041122000170 |
| Provider Name | Bruce Bertrand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215918891 PECOS PAC ID: 1355307315 Enrollment ID: I20041202000188 |
| Provider Name | Gloriane Afonso Fede |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376525063 PECOS PAC ID: 5597714329 Enrollment ID: I20050119000111 |
| Provider Name | Jorge M Medina |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477520930 PECOS PAC ID: 8123079621 Enrollment ID: I20050202000228 |
| Provider Name | Theophilus Vnm Addo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750479283 PECOS PAC ID: 1850343955 Enrollment ID: I20050217000146 |
| Provider Name | Jonathan Shapiro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962483222 PECOS PAC ID: 2264485648 Enrollment ID: I20050225000113 |
| Provider Name | Amin S Chaoui |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093787483 PECOS PAC ID: 9537112636 Enrollment ID: I20050301000756 |
| Provider Name | Robert W Conroy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528062858 PECOS PAC ID: 5597710012 Enrollment ID: I20050317000671 |
| Provider Name | Linda M Salzman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073508685 PECOS PAC ID: 8628039013 Enrollment ID: I20050323001102 |
| Provider Name | Stephen C Mackler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669442745 PECOS PAC ID: 9032008362 Enrollment ID: I20050324000094 |
| Provider Name | David L Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811915143 PECOS PAC ID: 6103872825 Enrollment ID: I20050325000336 |
| Provider Name | Johng H Chun |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1437144706 PECOS PAC ID: 4486601333 Enrollment ID: I20050404000563 |
| Provider Name | Paul G Vivino |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295717387 PECOS PAC ID: 9537149901 Enrollment ID: I20050411000981 |
| Provider Name | Roger S Pocze |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972579969 PECOS PAC ID: 6800834011 Enrollment ID: I20050419000820 |
| Provider Name | John W Bender |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578550695 PECOS PAC ID: 4486692639 Enrollment ID: I20050419001155 |
| Provider Name | Stephen L Keith |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1053367128 PECOS PAC ID: 5698713402 Enrollment ID: I20050421001207 |
| Provider Name | James P Tracey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235106105 PECOS PAC ID: 2466423900 Enrollment ID: I20050429000870 |
| Provider Name | John Niedzwicki |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1306812367 PECOS PAC ID: 3274572037 Enrollment ID: I20050502000006 |
| Provider Name | Diane S Messersmith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841239035 PECOS PAC ID: 0648219303 Enrollment ID: I20050502000923 |
| Provider Name | Pamela L Coury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598703944 PECOS PAC ID: 3476593070 Enrollment ID: I20050503000906 |
| Provider Name | Daniel J Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720058803 PECOS PAC ID: 2062452691 Enrollment ID: I20050503001132 |
| Provider Name | Gregg S Angell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578660429 PECOS PAC ID: 7416997325 Enrollment ID: I20050510001094 |
| Provider Name | Jonathan D Bier |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306883343 PECOS PAC ID: 4284625708 Enrollment ID: I20050517000854 |
| Provider Name | Robert E Nixon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447226329 PECOS PAC ID: 7416990155 Enrollment ID: I20050603000734 |
| Provider Name | Earl Potts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679560791 PECOS PAC ID: 1658312608 Enrollment ID: I20050617000560 |
| Provider Name | Mary R Dias-regus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326015496 PECOS PAC ID: 3577508282 Enrollment ID: I20050623000073 |
| Provider Name | Phoebe S Lewit Olhava |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568414696 PECOS PAC ID: 0042246936 Enrollment ID: I20050712000904 |
| Provider Name | James S Hoffman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790752772 PECOS PAC ID: 7810925468 Enrollment ID: I20050803000973 |
| Provider Name | Katherine E Frias |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316934441 PECOS PAC ID: 4688603384 Enrollment ID: I20050811000790 |
| Provider Name | Elliott J Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750358164 PECOS PAC ID: 1951331644 Enrollment ID: I20050812000375 |
| Provider Name | Suzanne M Caron |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548265473 PECOS PAC ID: 1658302716 Enrollment ID: I20050829000340 |
| Provider Name | Kenneth R Peelle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043264104 PECOS PAC ID: 9133186380 Enrollment ID: I20050907000123 |
| Provider Name | Jung Mi L. Haisman |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1447251152 PECOS PAC ID: 6709853062 Enrollment ID: I20050908000935 |
| Provider Name | Richard I Herman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316907116 PECOS PAC ID: 5698764397 Enrollment ID: I20050916000450 |
| Provider Name | Robert J Caldas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124032883 PECOS PAC ID: 2163448747 Enrollment ID: I20051022000249 |
| Provider Name | Richard Jennis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891777975 PECOS PAC ID: 9739100801 Enrollment ID: I20051216000216 |
| Provider Name | Mohamad H Ossiani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902867336 PECOS PAC ID: 7012922321 Enrollment ID: I20060208000035 |
| Provider Name | Minnietta M Pilgrim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700853231 PECOS PAC ID: 0345255519 Enrollment ID: I20060208000667 |
| Provider Name | Sandra M Sousa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770570897 PECOS PAC ID: 2264447481 Enrollment ID: I20060209000244 |
| Provider Name | Earl E Schott |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558316091 PECOS PAC ID: 4183619414 Enrollment ID: I20060302000270 |
| Provider Name | Sanford M Smoot |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720072697 PECOS PAC ID: 6103833488 Enrollment ID: I20060310000450 |
| Provider Name | John Niceforo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710972518 PECOS PAC ID: 4587683099 Enrollment ID: I20060328000207 |
| Provider Name | Kristen Fennessey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497830863 PECOS PAC ID: 2466461710 Enrollment ID: I20060413000468 |
| Provider Name | David R Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235126350 PECOS PAC ID: 5799795886 Enrollment ID: I20060503000813 |
| Provider Name | Steven B Andelman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669455051 PECOS PAC ID: 1355352980 Enrollment ID: I20060511000120 |
| Provider Name | Lucyna Z Czarnota Dolliver |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982632006 PECOS PAC ID: 3678585205 Enrollment ID: I20060626000126 |
| Provider Name | Zubin D Irani |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1154339612 PECOS PAC ID: 5294790184 Enrollment ID: I20060914000609 |
| Provider Name | Alexander L Feinstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306850367 PECOS PAC ID: 9436155116 Enrollment ID: I20061020000326 |
| Provider Name | George Ming Jen Wu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932217916 PECOS PAC ID: 1850398843 Enrollment ID: I20061106000179 |
| Provider Name | Ali Reza Niakosari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750362331 PECOS PAC ID: 3779560354 Enrollment ID: I20061109000564 |
| Provider Name | Mark J Leboeuf |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073647400 PECOS PAC ID: 0941305619 Enrollment ID: I20070425000358 |
| Provider Name | Mark A Ventura |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679619654 PECOS PAC ID: 4385740869 Enrollment ID: I20070430000214 |
| Provider Name | John J Pan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174740005 PECOS PAC ID: 1951402015 Enrollment ID: I20070719000739 |
| Provider Name | Shambhavi Venkataraman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174731533 PECOS PAC ID: 5294836920 Enrollment ID: I20070725000620 |
| Provider Name | Kaushal B Mehta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992926687 PECOS PAC ID: 6103918263 Enrollment ID: I20070821000028 |
| Provider Name | Janneth Y Romero |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144410234 PECOS PAC ID: 1052403581 Enrollment ID: I20070828000802 |
| Provider Name | Karen Sylvia Mcginnis |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1629006093 PECOS PAC ID: 4789614850 Enrollment ID: I20070829000818 |
| Provider Name | Joshua P Stein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013975671 PECOS PAC ID: 9234222647 Enrollment ID: I20070830000432 |
| Provider Name | Geetanjali Kulkarni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356531495 PECOS PAC ID: 7911090642 Enrollment ID: I20070911000335 |
| Provider Name | Hemlata K Daryani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679532691 PECOS PAC ID: 2062448715 Enrollment ID: I20070925000280 |
| Provider Name | Yung Hsin Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992756357 PECOS PAC ID: 6901818392 Enrollment ID: I20071005000194 |
| Provider Name | Parag Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245420348 PECOS PAC ID: 1153417969 Enrollment ID: I20071009000904 |
| Provider Name | Alexandra K Retana |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487797874 PECOS PAC ID: 4486740909 Enrollment ID: I20071015000326 |
| Provider Name | Anna Kozupa |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1376738039 PECOS PAC ID: 1557458866 Enrollment ID: I20071102000684 |
| Provider Name | Mary M Smyth |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1912964388 PECOS PAC ID: 2567559610 Enrollment ID: I20071106000457 |
| Provider Name | Maria P Petrillo Bolanos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700843919 PECOS PAC ID: 5193814705 Enrollment ID: I20071205000177 |
| Provider Name | Karmina P Bautista |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033131008 PECOS PAC ID: 2466541073 Enrollment ID: I20071205000184 |
| Provider Name | Neil L Denbow |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1699758839 PECOS PAC ID: 3476590456 Enrollment ID: I20071221000040 |
| Provider Name | Christine C Segal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023076833 PECOS PAC ID: 5193806685 Enrollment ID: I20080123000215 |
| Provider Name | Charles M Rosenthal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801904180 PECOS PAC ID: 0042264400 Enrollment ID: I20080128000705 |
| Provider Name | Michael J Rocha |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205874500 PECOS PAC ID: 0244312130 Enrollment ID: I20080131000137 |
| Provider Name | David J Shih |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134197429 PECOS PAC ID: 7911084546 Enrollment ID: I20080408000091 |
| Provider Name | Jeffrey D Potter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073649653 PECOS PAC ID: 6305923624 Enrollment ID: I20080410000134 |
| Provider Name | Matthew A Kippe |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841491396 PECOS PAC ID: 1456439553 Enrollment ID: I20080415000199 |
| Provider Name | Karen L Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316943798 PECOS PAC ID: 5890874358 Enrollment ID: I20080508000529 |
| Provider Name | Kerry P Gowell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922003870 PECOS PAC ID: 8325127616 Enrollment ID: I20080512000688 |
| Provider Name | Kelly F Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558551317 PECOS PAC ID: 8527137520 Enrollment ID: I20080516000347 |
| Provider Name | Ian A Rivera-colon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982819801 PECOS PAC ID: 4183793805 Enrollment ID: I20080521000637 |
| Provider Name | Karine Maalouf-kaleshian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114903663 PECOS PAC ID: 8729158506 Enrollment ID: I20080605000345 |
| Provider Name | Jeffrey J Michaud |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083619928 PECOS PAC ID: 6204907256 Enrollment ID: I20080618000438 |
| Provider Name | Stacey N Knox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346245297 PECOS PAC ID: 7012088065 Enrollment ID: I20080618000445 |
| Provider Name | Scott K Reid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699743526 PECOS PAC ID: 4082717673 Enrollment ID: I20080714000244 |
| Provider Name | Maria P Rumsey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023295516 PECOS PAC ID: 5294809794 Enrollment ID: I20080731000723 |
| Provider Name | Alissa J Saunders |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336363977 PECOS PAC ID: 0648344929 Enrollment ID: I20080805000198 |
| Provider Name | Robert Daly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578503181 PECOS PAC ID: 7315950896 Enrollment ID: I20080818000119 |
| Provider Name | Paul M Milhoua |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1306040589 PECOS PAC ID: 4284723727 Enrollment ID: I20080909000118 |
| Provider Name | Brian Ghoshhajra |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558539080 PECOS PAC ID: 1557438710 Enrollment ID: I20080930000449 |
| Provider Name | Sharon A Anderson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1083864110 PECOS PAC ID: 9234298324 Enrollment ID: I20081104000514 |
| Provider Name | Debby Almeida |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134289127 PECOS PAC ID: 2365467222 Enrollment ID: I20081125000701 |
| Provider Name | Portia Swain Silk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962695429 PECOS PAC ID: 9638242795 Enrollment ID: I20090618000297 |
| Provider Name | Yi Tang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720229149 PECOS PAC ID: 0648322826 Enrollment ID: I20090720000064 |
| Provider Name | Stephanie Van Colen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700045440 PECOS PAC ID: 3779638788 Enrollment ID: I20090827000066 |
| Provider Name | Charles K Heller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881828390 PECOS PAC ID: 4082769807 Enrollment ID: I20090831000614 |
| Provider Name | Eric David Schwartz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528093580 PECOS PAC ID: 0749172328 Enrollment ID: I20090910000457 |
| Provider Name | Brenda L Cabral |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295965804 PECOS PAC ID: 6608912712 Enrollment ID: I20091002000565 |
| Provider Name | Seyedehbatol Aleali |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659404267 PECOS PAC ID: 8123164191 Enrollment ID: I20091005000505 |
| Provider Name | Joely V Edwards |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558450049 PECOS PAC ID: 9335289859 Enrollment ID: I20091215000012 |
| Provider Name | Jahn Aubrey Pothier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962478966 PECOS PAC ID: 2769581263 Enrollment ID: I20100813000197 |
| Provider Name | Jose C Varghese |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366419319 PECOS PAC ID: 3072647320 Enrollment ID: I20100823000432 |
| Provider Name | Alvin Marcovici |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376530337 PECOS PAC ID: 3577687789 Enrollment ID: I20100825000239 |
| Provider Name | Eric R Levine |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528038734 PECOS PAC ID: 6800995390 Enrollment ID: I20100913000645 |
| Provider Name | Sirjana Dhungana Parajuli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063606473 PECOS PAC ID: 9133244247 Enrollment ID: I20100914000013 |
| Provider Name | Edward A Klein |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639149826 PECOS PAC ID: 2365541851 Enrollment ID: I20100924000528 |
| Provider Name | Bing Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699745810 PECOS PAC ID: 8628177110 Enrollment ID: I20100924000576 |
| Provider Name | German Velasco |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1447441472 PECOS PAC ID: 0840482428 Enrollment ID: I20101014000814 |
| Provider Name | Judith A Miesner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669448635 PECOS PAC ID: 0446359939 Enrollment ID: I20101019001551 |
| Provider Name | Christine A Will |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760458632 PECOS PAC ID: 2668571167 Enrollment ID: I20101116000697 |
| Provider Name | Allison Keel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114142932 PECOS PAC ID: 1052507787 Enrollment ID: I20101120000166 |
| Provider Name | James L Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225018062 PECOS PAC ID: 6901905496 Enrollment ID: I20101202001260 |
| Provider Name | Jeannette M Brash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245546175 PECOS PAC ID: 9335337617 Enrollment ID: I20101230000996 |
| Provider Name | Deborah D Kelly |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538212576 PECOS PAC ID: 8527247428 Enrollment ID: I20110125000302 |
| Provider Name | Roland J Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912986100 PECOS PAC ID: 4183723679 Enrollment ID: I20110128000504 |
| Provider Name | Kevin J Blount |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679795538 PECOS PAC ID: 6709957327 Enrollment ID: I20110310000587 |
| Provider Name | Nina Szulewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326349879 PECOS PAC ID: 9638353816 Enrollment ID: I20110413000127 |
| Provider Name | Sachin Maskey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134386972 PECOS PAC ID: 4385825587 Enrollment ID: I20110727000598 |
| Provider Name | Shams I Iqbal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386808608 PECOS PAC ID: 6406025790 Enrollment ID: I20110802000624 |
| Provider Name | Margaret Chung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518132083 PECOS PAC ID: 8426180753 Enrollment ID: I20110825000360 |
| Provider Name | Cheryl Pimentel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205126000 PECOS PAC ID: 2365613387 Enrollment ID: I20110923000509 |
| Provider Name | Ellen D Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952320350 PECOS PAC ID: 2062481898 Enrollment ID: I20111007000447 |
| Provider Name | Kimberly Green |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063793610 PECOS PAC ID: 3870766298 Enrollment ID: I20111101000016 |
| Provider Name | Celeste L Chace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700874096 PECOS PAC ID: 0143497354 Enrollment ID: I20120111000352 |
| Provider Name | Michelle Leblanc-gaffney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780671800 PECOS PAC ID: 8022277862 Enrollment ID: I20120314000135 |
| Provider Name | Lassalete G Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528055654 PECOS PAC ID: 6800055658 Enrollment ID: I20120314000203 |
| Provider Name | Kristen E Madden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699762716 PECOS PAC ID: 2961661715 Enrollment ID: I20120314000238 |
| Provider Name | Jordan C Gularek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346571098 PECOS PAC ID: 5294983755 Enrollment ID: I20120907000481 |
| Provider Name | Paul S Sepe |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528194958 PECOS PAC ID: 4486804150 Enrollment ID: I20121016000318 |
| Provider Name | Chad S Beattie |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1790946176 PECOS PAC ID: 5294985677 Enrollment ID: I20121019000474 |
| Provider Name | Kyle Tokarz |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1649242637 PECOS PAC ID: 3971783861 Enrollment ID: I20121113000469 |
| Provider Name | Mark Bobbin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639422637 PECOS PAC ID: 1951540434 Enrollment ID: I20130612000662 |
| Provider Name | Eugene I Tikh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942460068 PECOS PAC ID: 2062656473 Enrollment ID: I20130924000683 |
| Provider Name | Meagan L Fuertes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457784225 PECOS PAC ID: 6800022963 Enrollment ID: I20131119000977 |
| Provider Name | Achilles Romualso Alcaraz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245548643 PECOS PAC ID: 3274713292 Enrollment ID: I20140117001068 |
| Provider Name | Jong Liu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306952957 PECOS PAC ID: 1254362668 Enrollment ID: I20140124001815 |
| Provider Name | Ross A Wilson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093145385 PECOS PAC ID: 3870723299 Enrollment ID: I20140305000472 |
| Provider Name | Erica M Ahaesy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568891620 PECOS PAC ID: 4183855844 Enrollment ID: I20140321000194 |
| Provider Name | Jennifer Poirier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922424571 PECOS PAC ID: 1456583673 Enrollment ID: I20140422000783 |
| Provider Name | Heather M Dufour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063838811 PECOS PAC ID: 9739312703 Enrollment ID: I20140428000504 |
| Provider Name | Lauren E Conca |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962795104 PECOS PAC ID: 2365669017 Enrollment ID: I20140804002206 |
| Provider Name | Mary Fitzhugh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710155114 PECOS PAC ID: 9436330065 Enrollment ID: I20141031000598 |
| Provider Name | Kimberly D Witkowski |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598098857 PECOS PAC ID: 9830411693 Enrollment ID: I20141205000069 |
| Provider Name | Erica L Cabral |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275934382 PECOS PAC ID: 0840514923 Enrollment ID: I20150120001874 |
| Provider Name | William D Recupero |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1629193214 PECOS PAC ID: 6507004074 Enrollment ID: I20150406001342 |
| Provider Name | Timothy M Nace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669436408 PECOS PAC ID: 3577744119 Enrollment ID: I20150729008333 |
| Provider Name | Nathaniel M Cook |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1487903472 PECOS PAC ID: 9830405083 Enrollment ID: I20150902001369 |
| Provider Name | George Ganson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942490115 PECOS PAC ID: 9931365632 Enrollment ID: I20151008001715 |
| Provider Name | Melissa K Botelho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003215633 PECOS PAC ID: 3476853003 Enrollment ID: I20151203000557 |
| Provider Name | Jennifer A Sadeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033595210 PECOS PAC ID: 8123328614 Enrollment ID: I20151207000960 |
| Provider Name | Eshan A Patvardhan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497076046 PECOS PAC ID: 6709176357 Enrollment ID: I20160609001848 |
| Provider Name | Elie R Balesh |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1528353299 PECOS PAC ID: 0345403317 Enrollment ID: I20160621000274 |
| Provider Name | Justin D Etter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699113472 PECOS PAC ID: 8022309194 Enrollment ID: I20160630000984 |
| Provider Name | Gregory H Berberian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457662520 PECOS PAC ID: 4981902202 Enrollment ID: I20160818000532 |
| Provider Name | Brian Jin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811275266 PECOS PAC ID: 0143515262 Enrollment ID: I20160827000452 |
| Provider Name | John T Duell |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1598994261 PECOS PAC ID: 0345475109 Enrollment ID: I20160829001015 |
| Provider Name | Paula J Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376992610 PECOS PAC ID: 9830484997 Enrollment ID: I20160829001047 |
| Provider Name | Kelly E Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265981682 PECOS PAC ID: 0941589451 Enrollment ID: I20161125000011 |
| Provider Name | Mohsin Ghadiali |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417272667 PECOS PAC ID: 7618274432 Enrollment ID: I20170511001631 |
| Provider Name | Jonathan Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205123080 PECOS PAC ID: 3375810963 Enrollment ID: I20170602000936 |
| Provider Name | Andrew C Boylan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669734786 PECOS PAC ID: 6406125343 Enrollment ID: I20170707002177 |
| Provider Name | Kathryn R Wagner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043508617 PECOS PAC ID: 5092006486 Enrollment ID: I20170711000565 |
| Provider Name | Dietrich W.l. Schultze |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922192459 PECOS PAC ID: 8325939499 Enrollment ID: I20170817000178 |
| Provider Name | Helena H Meyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619265238 PECOS PAC ID: 7517253271 Enrollment ID: I20170821003324 |
| Provider Name | Ryan T Gates |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164686622 PECOS PAC ID: 7315171048 Enrollment ID: I20170918000253 |
| Provider Name | Nicholas J. Defusco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730593195 PECOS PAC ID: 4284926031 Enrollment ID: I20171012000406 |
| Provider Name | Adriana Medeiros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346760394 PECOS PAC ID: 2466728704 Enrollment ID: I20171101000038 |
| Provider Name | Nancy A Resteghini |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205122876 PECOS PAC ID: 2365740222 Enrollment ID: I20171101000279 |
| Provider Name | Zhenhong Li |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1811275506 PECOS PAC ID: 4688930571 Enrollment ID: I20171109000494 |
| Provider Name | Joymon K Sebastian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437668241 PECOS PAC ID: 0244599371 Enrollment ID: I20180118001882 |
| Provider Name | Annapurna Chavali Rao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275648131 PECOS PAC ID: 8325079437 Enrollment ID: I20180226000194 |
| Provider Name | Gabriella Maria Cardoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942718184 PECOS PAC ID: 7315209400 Enrollment ID: I20180330000413 |
| Provider Name | Annalise J Boisvert |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689962623 PECOS PAC ID: 4082845391 Enrollment ID: I20180508001218 |
| Provider Name | Haralampos Kamenidis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1184069056 PECOS PAC ID: 6800151291 Enrollment ID: I20180606002086 |
| Provider Name | Rachel E Hoffmann |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1699187575 PECOS PAC ID: 7517216229 Enrollment ID: I20180814000670 |
| Provider Name | Shan Qin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891138822 PECOS PAC ID: 7113212234 Enrollment ID: I20180821003581 |
| Provider Name | Malavika Bhalla |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447546403 PECOS PAC ID: 2365757895 Enrollment ID: I20181207002095 |
| Provider Name | Michael E Click |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952363053 PECOS PAC ID: 2365483518 Enrollment ID: I20190402002898 |
| Provider Name | Anthony B Karabanow |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1336183623 PECOS PAC ID: 3779556121 Enrollment ID: I20190703001142 |
| Provider Name | Maureen Frederick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225457070 PECOS PAC ID: 6002145737 Enrollment ID: I20190905002805 |
| Provider Name | Charles E Beale |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1407146962 PECOS PAC ID: 1658598065 Enrollment ID: I20191021001077 |
| Provider Name | Rola Benayad-cherif |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326214123 PECOS PAC ID: 1850724121 Enrollment ID: I20191129000167 |
| Provider Name | Jennifer L Jackman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194385658 PECOS PAC ID: 9638502289 Enrollment ID: I20191212000573 |
| Provider Name | Justin C Laprise |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477061547 PECOS PAC ID: 7911255229 Enrollment ID: I20191217000373 |
| Provider Name | Zivile Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972141232 PECOS PAC ID: 9537595780 Enrollment ID: I20200206000082 |
| Provider Name | Colleen Buffington |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134122583 PECOS PAC ID: 5597744136 Enrollment ID: I20200210000585 |
| Provider Name | Luke Barre |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1689938037 PECOS PAC ID: 9032408539 Enrollment ID: I20200227000693 |
| Provider Name | Jill Wruble |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396717666 PECOS PAC ID: 3173515632 Enrollment ID: I20200324000404 |
| Provider Name | Autumn S Makowski |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1598305856 PECOS PAC ID: 2769812874 Enrollment ID: I20200413002993 |
| Provider Name | Gisele Cruz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669824389 PECOS PAC ID: 9931495827 Enrollment ID: I20200526001505 |
| Provider Name | Leandro Leite |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750693800 PECOS PAC ID: 2466691035 Enrollment ID: I20200610001381 |
| Provider Name | Michael Dowe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376589390 PECOS PAC ID: 2466441191 Enrollment ID: I20200611003127 |
| Provider Name | Colm Mccarthy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982269205 PECOS PAC ID: 6204251655 Enrollment ID: I20200803001846 |
| Provider Name | Krishna V Iyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003837634 PECOS PAC ID: 5395741326 Enrollment ID: I20200804000537 |
| Provider Name | John I Meyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144640095 PECOS PAC ID: 2567708308 Enrollment ID: I20200806000796 |
| Provider Name | Ali Farzan Jon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184035693 PECOS PAC ID: 2062831936 Enrollment ID: I20200925000561 |
| Provider Name | Hannah M Liebman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366975401 PECOS PAC ID: 0446523401 Enrollment ID: I20201021001696 |
| Provider Name | Adeel Seyal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023225406 PECOS PAC ID: 4082766431 Enrollment ID: I20201105001865 |
| Provider Name | Nancy M Moniz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215542964 PECOS PAC ID: 6204247463 Enrollment ID: I20201119003387 |
| Provider Name | Sarah G Ivanova |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891399739 PECOS PAC ID: 5799197992 Enrollment ID: I20201211001854 |
| Provider Name | Ali Alikhani |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1336582519 PECOS PAC ID: 6204072986 Enrollment ID: I20201219000058 |
| Provider Name | Liang Zhang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922369313 PECOS PAC ID: 2769895598 Enrollment ID: I20210115000262 |
| Provider Name | Sohaib Altaf |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942677000 PECOS PAC ID: 1355765785 Enrollment ID: I20210603000156 |
| Provider Name | Gisele Yadje Choo Arrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962908483 PECOS PAC ID: 9537417829 Enrollment ID: I20210713002750 |
| Provider Name | Amanda Rose Howland |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1083064208 PECOS PAC ID: 4981991577 Enrollment ID: I20210804003489 |
| Provider Name | Aileen Souza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598261745 PECOS PAC ID: 9739437021 Enrollment ID: I20210818002467 |
| Provider Name | Audrey Harrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013304625 PECOS PAC ID: 0840507158 Enrollment ID: I20210907002690 |
| Provider Name | Kimberly Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235622960 PECOS PAC ID: 8123416591 Enrollment ID: I20211104000970 |
| Provider Name | Sonia M Clavin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568129567 PECOS PAC ID: 0840682464 Enrollment ID: I20220111002064 |
| Provider Name | Danielle L Bouchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396261863 PECOS PAC ID: 3870985492 Enrollment ID: I20220111002369 |
| Provider Name | Christopher M Conti |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598424657 PECOS PAC ID: 4789076134 Enrollment ID: I20220118000337 |
| Provider Name | Chelsea M Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326701301 PECOS PAC ID: 3577958099 Enrollment ID: I20220321001240 |
| Provider Name | Justin G Matrisciano |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1922093210 PECOS PAC ID: 8426948092 Enrollment ID: I20220421000012 |
| Provider Name | Phoebe R L Martin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801391826 PECOS PAC ID: 3870841455 Enrollment ID: I20220421001642 |
| Provider Name | Selina Avelino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831839059 PECOS PAC ID: 8921495326 Enrollment ID: I20220504001538 |
| Provider Name | Melissa H Arruda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013662402 PECOS PAC ID: 5294112553 Enrollment ID: I20220507000065 |
| Provider Name | Daniel Chonde |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457889560 PECOS PAC ID: 5496026510 Enrollment ID: I20220613000785 |
| Provider Name | Ian Ross Mccaslin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1720422439 PECOS PAC ID: 9931527579 Enrollment ID: I20220621000170 |
| Provider Name | Javelle A Wynter |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1659799906 PECOS PAC ID: 2769604263 Enrollment ID: I20220628001080 |
| Provider Name | Bobby Joseph |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558721803 PECOS PAC ID: 8022308980 Enrollment ID: I20220706000884 |
| Provider Name | Andrea Pereira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598403073 PECOS PAC ID: 6901287010 Enrollment ID: I20220721000491 |
| Provider Name | Katrina A Ressler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801392477 PECOS PAC ID: 0648516468 Enrollment ID: I20220812001434 |
| Provider Name | Veronica H Fernandes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760114730 PECOS PAC ID: 2668856469 Enrollment ID: I20220829000440 |
| Provider Name | Kayla M O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699351643 PECOS PAC ID: 5193101590 Enrollment ID: I20221010000798 |
| Provider Name | Raya Hazem Hamed Alhalawani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962885749 PECOS PAC ID: 1153798616 Enrollment ID: I20221114000963 |
| Provider Name | Kimberly A Swail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881341402 PECOS PAC ID: 6204201023 Enrollment ID: I20230410001783 |
| Provider Name | Rebecca Nunes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588216444 PECOS PAC ID: 6204291743 Enrollment ID: I20230505000313 |
| Provider Name | Jose J Santiago |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689023178 PECOS PAC ID: 2264897685 Enrollment ID: I20230508000896 |
| Provider Name | Amber Miranda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386247682 PECOS PAC ID: 2961869276 Enrollment ID: I20230601000520 |
| Provider Name | Carol Hudner |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1265586861 PECOS PAC ID: 5799847935 Enrollment ID: I20230602000182 |
| Provider Name | Marie A Gallagher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952099368 PECOS PAC ID: 0143687715 Enrollment ID: I20230613002290 |
| Provider Name | Mary Brogno-constantine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114642519 PECOS PAC ID: 2466811930 Enrollment ID: I20230630000608 |
| Provider Name | Ashley L Vertente |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275162760 PECOS PAC ID: 6204257173 Enrollment ID: I20230706001632 |
| Provider Name | Caitlin M Arruda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346996238 PECOS PAC ID: 9830558048 Enrollment ID: I20230706002597 |
| Provider Name | Evelyn Salvador |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285318238 PECOS PAC ID: 9739543778 Enrollment ID: I20230911000804 |
| Provider Name | Wanda Nunes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477235711 PECOS PAC ID: 7618323726 Enrollment ID: I20231026000352 |
| Provider Name | Courtney Elizabeth Tracy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285332866 PECOS PAC ID: 4789040213 Enrollment ID: I20231031002523 |
| Provider Name | Cintia Condez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992584551 PECOS PAC ID: 5395194781 Enrollment ID: I20231211001834 |
| Provider Name | Jaelyn E Gomes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346025186 PECOS PAC ID: 3375996507 Enrollment ID: I20240124002073 |
Family Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 72 State Rd, Dartmouth, MA 02747 Phone: 508-999-9633 | |
Premier Healthcare Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 77 Wolcott Ave, Dartmouth, MA 02747 Phone: 774-202-7049 Fax: 774-202-2839 | |
Imagine Primary Care, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 370 Faunce Corner Rd Ste 103, Dartmouth, MA 02747 Phone: 774-264-0932 | |
Mw Wellness Ventures Iv Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 370 Faunce Corner Rd, Dartmouth, MA 02747 Phone: 813-228-6334 | |
Prime Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 237a State Rd, Dartmouth, MA 02747 Phone: 508-742-5471 | |
The Children's Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 88 Faunce Corner Rd Unit 250, Dartmouth, MA 02747 Phone: 774-320-0182 Fax: 508-999-9941 | |
Pulmonary And Sleep Medicine Associates Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 370 Faunce Corner Rd Fl 2, Dartmouth, MA 02747 Phone: 508-998-3041 Fax: 508-998-3043 |