| Tru Medical Management | |
|
774 Broadway Ste 2b Brooklyn NY 11206-5316 | |
| (347) 335-0305 | |
| (718) 638-2043 |
| Full Name | Tru Medical Management |
|---|---|
| Speciality | Internal Medicine |
| Location | 774 Broadway Ste 2b, Brooklyn, New York |
| Authorized Official Name and Position | Hari K Polavarapu (PRESIDENT) |
| Authorized Official Contact | 3473350305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tru Medical Management 333 Rector Pl Apt 504 New York NY 10280-1214 Ph: (917) 454-8474 | Tru Medical Management 774 Broadway Ste 2b Brooklyn NY 11206-5316 Ph: (347) 335-0305 |
| NPI Number | 1619944550 |
|---|---|
| Provider Enumeration Date | 02/28/2006 |
| Last Update Date | 12/14/2022 |
| Certification Date | 12/14/2022 |
| Medicare PECOS PAC ID | 2961442546 |
|---|---|
| Medicare Enrollment ID | O20090506000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619944550 | NPI | - | NPPES |
| 02142478 | Medicaid | NY | |
| 03520041 | Medicaid | NY |
| Provider Name | Hari K Polavarapu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760551816 PECOS PAC ID: 0941271373 Enrollment ID: I20040802000299 |
| Provider Name | Satya S. Polavarapu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407815152 PECOS PAC ID: 2567409170 Enrollment ID: I20050414001178 |
| Provider Name | Jacqueline Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558638916 PECOS PAC ID: 9739344185 Enrollment ID: I20120710000166 |
| Provider Name | Brendan Farnand |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245739333 PECOS PAC ID: 6204198310 Enrollment ID: I20180328003141 |
| Provider Name | Angelique Miste Saavedra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992304604 PECOS PAC ID: 4789095936 Enrollment ID: I20201119002577 |
| Provider Name | Paul Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003310699 PECOS PAC ID: 2062817836 Enrollment ID: I20210818000509 |
| Provider Name | Megan Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891377990 PECOS PAC ID: 3779973870 Enrollment ID: I20230801003035 |
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