| Tidalhealth Physician Network, Inc. | |
|
801 Middleford Rd Seaford DE 19973-3636 | |
| (302) 629-5217 | |
| Not Available |
| Full Name | Tidalhealth Physician Network, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 801 Middleford Rd, Seaford, Delaware |
| Authorized Official Name and Position | Denise Jester (SENIOR DIRECTOR OF FINANCE) |
| Authorized Official Contact | 3026296611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidalhealth Physician Network, Inc. 801 Middleford Rd Seaford DE 19973-3636 Ph: (302) 629-6611 | Tidalhealth Physician Network, Inc. 801 Middleford Rd Seaford DE 19973-3636 Ph: (302) 629-5217 |
| NPI Number | 1467534636 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 03/02/2023 |
| Medicare PECOS PAC ID | 7315901253 |
|---|---|
| Medicare Enrollment ID | O20041119000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467534636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Khalil F Gorgui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225076375 PECOS PAC ID: 6800783606 Enrollment ID: I20040304000310 |
| Provider Name | Tammy Walbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710986187 PECOS PAC ID: 2264416957 Enrollment ID: I20040618000265 |
| Provider Name | Julia Seeley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841325610 PECOS PAC ID: 8022097989 Enrollment ID: I20040715000535 |
| Provider Name | Cynthia S Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134199029 PECOS PAC ID: 7315962685 Enrollment ID: I20051006000392 |
| Provider Name | Linda Barriocanal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891870267 PECOS PAC ID: 5698793370 Enrollment ID: I20051110000917 |
| Provider Name | Abha Gupta |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295877231 PECOS PAC ID: 3971523150 Enrollment ID: I20051202000235 |
| Provider Name | Joseph H Kim |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114965167 PECOS PAC ID: 6103834882 Enrollment ID: I20060323000138 |
| Provider Name | Keith A Sargent |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952595506 PECOS PAC ID: 3375613839 Enrollment ID: I20080610000480 |
| Provider Name | Ian Baxter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902890148 PECOS PAC ID: 4183654312 Enrollment ID: I20080721000388 |
| Provider Name | Victorino L Dejesus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699713032 PECOS PAC ID: 1658449889 Enrollment ID: I20081001000335 |
| Provider Name | Arthur Jones |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053323980 PECOS PAC ID: 0345346250 Enrollment ID: I20081030000634 |
| Provider Name | Beverly A Van Schaik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467421180 PECOS PAC ID: 2860572948 Enrollment ID: I20081222000062 |
| Provider Name | Janet T Pedro |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518061621 PECOS PAC ID: 2567471360 Enrollment ID: I20090528000269 |
| Provider Name | Ronald Concha Parra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275737652 PECOS PAC ID: 7214080837 Enrollment ID: I20090729000847 |
| Provider Name | Jose L Barriocanal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003873415 PECOS PAC ID: 6406998483 Enrollment ID: I20100129000066 |
| Provider Name | Joseph F Karnish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427002690 PECOS PAC ID: 1557404118 Enrollment ID: I20100204000169 |
| Provider Name | Jo Ann Fields |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386612844 PECOS PAC ID: 3678568979 Enrollment ID: I20100708000916 |
| Provider Name | Stephen D Carey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326110511 PECOS PAC ID: 8527190172 Enrollment ID: I20100716000240 |
| Provider Name | Walton Reddish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669548574 PECOS PAC ID: 6002949666 Enrollment ID: I20100803000357 |
| Provider Name | Jennifer Ketterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306157508 PECOS PAC ID: 4284821067 Enrollment ID: I20101206000730 |
| Provider Name | John A Appiott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669440681 PECOS PAC ID: 5496787947 Enrollment ID: I20101221000556 |
| Provider Name | Joaquin Cabrera |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063517381 PECOS PAC ID: 7416146675 Enrollment ID: I20110104001062 |
| Provider Name | Francisco Padilla |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1831399310 PECOS PAC ID: 0648448316 Enrollment ID: I20110725000077 |
| Provider Name | Elizabeth A Kornfield Chadwell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245235365 PECOS PAC ID: 8224113105 Enrollment ID: I20110930000121 |
| Provider Name | Christine Hannaway |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336373430 PECOS PAC ID: 8729127923 Enrollment ID: I20111109000691 |
| Provider Name | Sandra Palavecino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619104874 PECOS PAC ID: 9931357811 Enrollment ID: I20120918000798 |
| Provider Name | Valerie A Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619230778 PECOS PAC ID: 8729236633 Enrollment ID: I20120919000223 |
| Provider Name | David E Eakin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518076579 PECOS PAC ID: 8921140989 Enrollment ID: I20130130000097 |
| Provider Name | Raju Maharjan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033367578 PECOS PAC ID: 2567601909 Enrollment ID: I20130617000201 |
| Provider Name | Jessica W Baxter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215372479 PECOS PAC ID: 8022257971 Enrollment ID: I20130625000568 |
| Provider Name | Donna G Hitchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710229711 PECOS PAC ID: 7719128651 Enrollment ID: I20130718000730 |
| Provider Name | Helen Brogan Vansant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588643571 PECOS PAC ID: 8628069739 Enrollment ID: I20140317000386 |
| Provider Name | Mark Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669447637 PECOS PAC ID: 8527050582 Enrollment ID: I20140909001041 |
| Provider Name | David W Cohen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922191568 PECOS PAC ID: 8325055775 Enrollment ID: I20140924001569 |
| Provider Name | Catherine A Barber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124424627 PECOS PAC ID: 5193048841 Enrollment ID: I20150105000117 |
| Provider Name | Brenda I King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255745766 PECOS PAC ID: 8325363583 Enrollment ID: I20150210000767 |
| Provider Name | Tanya V Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255720413 PECOS PAC ID: 0648596544 Enrollment ID: I20150312001715 |
| Provider Name | Tarek M Waked Hammoud |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699941864 PECOS PAC ID: 4183870918 Enrollment ID: I20150416002107 |
| Provider Name | Kristi R Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841683844 PECOS PAC ID: 5890016331 Enrollment ID: I20150609000930 |
| Provider Name | Karini A Maximoss |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1871937003 PECOS PAC ID: 8921224981 Enrollment ID: I20150625001655 |
| Provider Name | Candace Mcknight Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578553962 PECOS PAC ID: 2062547771 Enrollment ID: I20150812007320 |
| Provider Name | Kunal Agarwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932497773 PECOS PAC ID: 4082846860 Enrollment ID: I20150930000545 |
| Provider Name | Sandra Mancilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033247325 PECOS PAC ID: 9830261221 Enrollment ID: I20151104001096 |
| Provider Name | Edda E Didonato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306253281 PECOS PAC ID: 5698077238 Enrollment ID: I20160113001987 |
| Provider Name | Ghassan Kanj |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649359944 PECOS PAC ID: 7113914730 Enrollment ID: I20160201002894 |
| Provider Name | Kimberly S Hyatt |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740562503 PECOS PAC ID: 5496045064 Enrollment ID: I20160609002383 |
| Provider Name | William R Doran |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790070035 PECOS PAC ID: 5991099194 Enrollment ID: I20160811000417 |
| Provider Name | Deepa Bhanot |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184936890 PECOS PAC ID: 0547416927 Enrollment ID: I20160822000940 |
| Provider Name | Kendol Kirk Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013357375 PECOS PAC ID: 9739474172 Enrollment ID: I20160824000312 |
| Provider Name | Ismet Lukolic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275777039 PECOS PAC ID: 4082900154 Enrollment ID: I20160916000079 |
| Provider Name | Areej Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821495326 PECOS PAC ID: 7416230560 Enrollment ID: I20170215001320 |
| Provider Name | Erika L Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952723454 PECOS PAC ID: 7113201047 Enrollment ID: I20170221001477 |
| Provider Name | Wendy L Corkran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003357211 PECOS PAC ID: 5597835694 Enrollment ID: I20170718000642 |
| Provider Name | Keenon M White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447428636 PECOS PAC ID: 5890910038 Enrollment ID: I20170815000626 |
| Provider Name | Shalini Verma |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1972720225 PECOS PAC ID: 6305019316 Enrollment ID: I20170913000509 |
| Provider Name | Dana M Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205354453 PECOS PAC ID: 4284900499 Enrollment ID: I20171016002109 |
| Provider Name | Ashley Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104358126 PECOS PAC ID: 3072880616 Enrollment ID: I20171218002122 |
| Provider Name | Kimberly A Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427573336 PECOS PAC ID: 8224397971 Enrollment ID: I20180125002469 |
| Provider Name | Melody Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174050447 PECOS PAC ID: 8123399136 Enrollment ID: I20180413001740 |
| Provider Name | Patricia Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033465166 PECOS PAC ID: 4284901257 Enrollment ID: I20180515002326 |
| Provider Name | Halim N Charbel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740431501 PECOS PAC ID: 0446306914 Enrollment ID: I20180604001616 |
| Provider Name | Ahmad Elayyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366884785 PECOS PAC ID: 4688985419 Enrollment ID: I20180730000372 |
| Provider Name | Kurt Wehberg |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1275507535 PECOS PAC ID: 0244372613 Enrollment ID: I20180821003733 |
| Provider Name | Eman Mazloum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265848980 PECOS PAC ID: 9739490293 Enrollment ID: I20181005001162 |
| Provider Name | Heather M Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093270357 PECOS PAC ID: 2264773985 Enrollment ID: I20190408000381 |
| Provider Name | Donjurea Daniels |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1598322141 PECOS PAC ID: 4880928829 Enrollment ID: I20190626000394 |
| Provider Name | Amanda Watson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1962056119 PECOS PAC ID: 4385973932 Enrollment ID: I20190909000676 |
| Provider Name | Melissa M Kestler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255988770 PECOS PAC ID: 0547591299 Enrollment ID: I20191010000079 |
| Provider Name | Heather Haddock |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1841846979 PECOS PAC ID: 4284965534 Enrollment ID: I20191017000958 |
| Provider Name | Maritza G Parreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215048871 PECOS PAC ID: 9739302076 Enrollment ID: I20191018000729 |
| Provider Name | Peter Lerza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316591647 PECOS PAC ID: 4183956238 Enrollment ID: I20191023001187 |
| Provider Name | Monica L Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700421062 PECOS PAC ID: 5890129829 Enrollment ID: I20191230001208 |
| Provider Name | Michelle Talag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114319738 PECOS PAC ID: 8426489279 Enrollment ID: I20200511001559 |
| Provider Name | Melissa D Meredith |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427090745 PECOS PAC ID: 6103813977 Enrollment ID: I20200814001906 |
| Provider Name | Maria Lourdes De Castro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487178083 PECOS PAC ID: 6507138757 Enrollment ID: I20200903000063 |
| Provider Name | Jeffery J Dorociak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407805328 PECOS PAC ID: 0345231973 Enrollment ID: I20200922000060 |
| Provider Name | Suguna Chirla |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1124105176 PECOS PAC ID: 1850465865 Enrollment ID: I20201014002154 |
| Provider Name | Antonio Granda |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780624023 PECOS PAC ID: 9739262346 Enrollment ID: I20210204000198 |
| Provider Name | Martin Melson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265978944 PECOS PAC ID: 2668771130 Enrollment ID: I20210413003027 |
| Provider Name | Makondo Shimukowa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730389982 PECOS PAC ID: 6002970332 Enrollment ID: I20210714002096 |
| Provider Name | Stephen G Keim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821080029 PECOS PAC ID: 1052394582 Enrollment ID: I20210719003599 |
| Provider Name | Karen Barbosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568472355 PECOS PAC ID: 7113923962 Enrollment ID: I20210923000511 |
| Provider Name | Purna Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902391675 PECOS PAC ID: 7315344033 Enrollment ID: I20210923000520 |
| Provider Name | Hazem Ahmed Elariny |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649203118 PECOS PAC ID: 8729045042 Enrollment ID: I20210929002005 |
| Provider Name | Jarrod Buzalewski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134546955 PECOS PAC ID: 3274837323 Enrollment ID: I20211004000050 |
| Provider Name | Ammar Mohammed Alhaddad |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1558756619 PECOS PAC ID: 7416259007 Enrollment ID: I20211019000142 |
| Provider Name | Felipe Orellana |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457756124 PECOS PAC ID: 8224373774 Enrollment ID: I20211105000627 |
| Provider Name | Erik C Osborn |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659471472 PECOS PAC ID: 6305022302 Enrollment ID: I20211105001117 |
| Provider Name | Jacques R Conaway |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437245362 PECOS PAC ID: 2769519701 Enrollment ID: I20211130000033 |
| Provider Name | Sean Janzer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518962331 PECOS PAC ID: 6507757184 Enrollment ID: I20211229000161 |
| Provider Name | Marie J Polynice |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265738371 PECOS PAC ID: 5294973210 Enrollment ID: I20220110000990 |
| Provider Name | Eduardo E Robles-emanuelli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740229251 PECOS PAC ID: 4688601099 Enrollment ID: I20220112001540 |
| Provider Name | Geri Renae Iames |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144792961 PECOS PAC ID: 3173869054 Enrollment ID: I20220309000209 |
| Provider Name | Yashvir Sangwan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205097698 PECOS PAC ID: 8729255641 Enrollment ID: I20220309000389 |
| Provider Name | Jeannette Daum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548772577 PECOS PAC ID: 6406114099 Enrollment ID: I20220309001236 |
| Provider Name | Abbas Omais |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699748046 PECOS PAC ID: 9133213226 Enrollment ID: I20220309002223 |
| Provider Name | Alyson N Heenan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1285106393 PECOS PAC ID: 6204174949 Enrollment ID: I20220330003065 |
| Provider Name | Kristen Mcgronan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255004107 PECOS PAC ID: 1557757598 Enrollment ID: I20220331000756 |
| Provider Name | Nicholas J Dudas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780668913 PECOS PAC ID: 0042212946 Enrollment ID: I20220504000708 |
| Provider Name | Danniell Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649847583 PECOS PAC ID: 3173900198 Enrollment ID: I20220513000078 |
| Provider Name | Sandra Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558317602 PECOS PAC ID: 7113181330 Enrollment ID: I20220616001187 |
| Provider Name | Reshmi Udesh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770014474 PECOS PAC ID: 7315216850 Enrollment ID: I20220825002217 |
| Provider Name | Holly Schreiber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750990958 PECOS PAC ID: 8325468432 Enrollment ID: I20220929000072 |
| Provider Name | Rajiv Dhawan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710967005 PECOS PAC ID: 8426950791 Enrollment ID: I20221010001880 |
| Provider Name | Nichole Nasha Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588202600 PECOS PAC ID: 9931535853 Enrollment ID: I20221031000162 |
| Provider Name | Henry M Degroot |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1710958723 PECOS PAC ID: 3971539693 Enrollment ID: I20221102000023 |
| Provider Name | Jeffrey M Schulman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033148614 PECOS PAC ID: 4981708989 Enrollment ID: I20221117003395 |
| Provider Name | Richard Mcneilly |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093087611 PECOS PAC ID: 0547568586 Enrollment ID: I20221123000277 |
| Provider Name | Akhil Parashar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205246477 PECOS PAC ID: 2062782253 Enrollment ID: I20221201001511 |
| Provider Name | William Murrell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134109572 PECOS PAC ID: 9638164353 Enrollment ID: I20221207000066 |
| Provider Name | Amen Sergew |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407993769 PECOS PAC ID: 6800813916 Enrollment ID: I20230111001001 |
| Provider Name | Malene K Ingram |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013018829 PECOS PAC ID: 8224132568 Enrollment ID: I20230123000499 |
| Provider Name | Mary Beth Dickerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689005225 PECOS PAC ID: 5991191306 Enrollment ID: I20230217000573 |
| Provider Name | David L Sechler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386626869 PECOS PAC ID: 3274658760 Enrollment ID: I20230222000452 |
| Provider Name | Mary Williams-feldman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194117895 PECOS PAC ID: 3870811995 Enrollment ID: I20230331001271 |
| Provider Name | Faith M Lauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932810793 PECOS PAC ID: 0648645663 Enrollment ID: I20230405000802 |
| Provider Name | Conor Mclaughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326559980 PECOS PAC ID: 6608231444 Enrollment ID: I20230428002474 |
| Provider Name | Jeanette M Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154694065 PECOS PAC ID: 8729249149 Enrollment ID: I20230520000199 |
| Provider Name | Francina Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780388819 PECOS PAC ID: 4981061082 Enrollment ID: I20230606000162 |
| Provider Name | Audrey Ormberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891781506 PECOS PAC ID: 1850329822 Enrollment ID: I20230624000341 |
| Provider Name | Eleazar O'garro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164650610 PECOS PAC ID: 3274777073 Enrollment ID: I20230801002552 |
| Provider Name | Terry Angell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518313311 PECOS PAC ID: 9335439231 Enrollment ID: I20230821000718 |
| Provider Name | Alice K Melvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568174704 PECOS PAC ID: 4284097718 Enrollment ID: I20230830003133 |
| Provider Name | Andrew Curley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447614417 PECOS PAC ID: 8628472230 Enrollment ID: I20230926002189 |
| Provider Name | Milcah Larks |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1922010081 PECOS PAC ID: 9931286051 Enrollment ID: I20231218003564 |
| Provider Name | Stuart Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205617305 PECOS PAC ID: 8325498785 Enrollment ID: I20231227001471 |
| Provider Name | Alfred W Lee-young |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689732240 PECOS PAC ID: 1456401348 Enrollment ID: I20240125001265 |
Jiloca Dejesus Jiloca Mdpa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 A Front Street, Seaford, DE 19973 Phone: 302-629-4569 Fax: 302-628-4669 | |
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