| Victa Llc | |
|
110 Elmwood Ave # A Providence RI 02907 | |
| (401) 868-0654 | |
| Not Available |
| Full Name | Victa Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 110 Elmwood Ave # A, Providence, Rhode Island |
| Authorized Official Name and Position | Alexander Donoyan (CEO) |
| Authorized Official Contact | 4013005757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Victa Llc 110 Elmwood Ave Providence RI 02907-2423 Ph: (401) 300-5757 | Victa Llc 110 Elmwood Ave # A Providence RI 02907 Ph: (401) 868-0654 |
| NPI Number | 1104317007 |
|---|---|
| Provider Enumeration Date | 05/25/2018 |
| Last Update Date | 02/21/2019 |
| Medicare PECOS PAC ID | 0840620894 |
|---|---|
| Medicare Enrollment ID | O20200415002461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104317007 | NPI | - | NPPES |
| Provider Name | Karen Mcdonald |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1841236718 PECOS PAC ID: 5890762470 Enrollment ID: I20040914000004 |
| Provider Name | Michael James Weaver |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215995097 PECOS PAC ID: 3779548623 Enrollment ID: I20041119000940 |
| Provider Name | Cheryl Brodsky |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376523829 PECOS PAC ID: 8325004815 Enrollment ID: I20041207000236 |
| Provider Name | Jeremy S Thayer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518094846 PECOS PAC ID: 1557410636 Enrollment ID: I20090520000124 |
| Provider Name | Sylvester C Sviokla |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1205850989 PECOS PAC ID: 1850722422 Enrollment ID: I20200514002173 |
| Provider Name | Lisa Marie Rodrigues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639454572 PECOS PAC ID: 3476728858 Enrollment ID: I20220107001899 |
| Provider Name | Matthew B. Perry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962965905 PECOS PAC ID: 8325376528 Enrollment ID: I20221104001829 |
| Provider Name | Lisa A Peterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962514869 PECOS PAC ID: 3577993526 Enrollment ID: I20240426000159 |
Kevin E. Baill Md & Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 Blackstone Blvd, Providence, RI 02906 Phone: 917-447-2138 | |
Ocean State Urgent Care At St Joseph Health Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 Peace St, Providence, RI 02907 Phone: 301-314-3999 Fax: 401-808-6294 | |
Theodore C. Palumbo, Md, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 33 Staniford St, Providence, RI 02905 Phone: 401-421-8800 Fax: 401-273-6510 | |
Concentra Primary Care Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 290 Branch Ave, Providence, RI 02904 Phone: 401-722-8880 Fax: 401-723-9320 | |
Barrington Urgent Care, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 381 Wickenden St, Providence, RI 02903 Phone: 401-433-7550 Fax: 401-490-0905 | |
Episcopal Housing Foundation Of Rhode Island Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 66 Benefit St, Providence, RI 02904 Phone: 401-274-4505 | |
Manzolillo Chiropractic Center Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 280 Broadway, Providence, RI 02903 Phone: 401-273-0046 Fax: 401-273-4100 |