| Visavis Health Care Medical Group Of Pennsylvania Pllc | |
|
30 West Ave Wayne PA 19087-3322 | |
| (212) 734-6621 | |
| Not Available |
| Full Name | Visavis Health Care Medical Group Of Pennsylvania Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 30 West Ave, Wayne, Pennsylvania |
| Authorized Official Name and Position | Yitty Falkowitz (OWNER) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visavis Health Care Medical Group Of Pennsylvania Pllc 250 Skillman St Ste 202 Brooklyn NY 11205-1218 Ph: (212) 734-6621 | Visavis Health Care Medical Group Of Pennsylvania Pllc 30 West Ave Wayne PA 19087-3322 Ph: (212) 734-6621 |
| NPI Number | 1619688132 |
|---|---|
| Provider Enumeration Date | 12/06/2022 |
| Last Update Date | 08/22/2023 |
| Medicare PECOS PAC ID | 6305218850 |
|---|---|
| Medicare Enrollment ID | O20230209000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619688132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Cynthia Menzoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104963743 PECOS PAC ID: 0345343877 Enrollment ID: I20070321000232 |
| Provider Name | Sherdina Hobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104153055 PECOS PAC ID: 3173431640 Enrollment ID: I20100306000245 |
| Provider Name | Bernadette Sherman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275882292 PECOS PAC ID: 4789813767 Enrollment ID: I20140218000006 |
| Provider Name | Jessica Fichter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447643986 PECOS PAC ID: 5698087732 Enrollment ID: I20150702001400 |
| Provider Name | Jodie L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891248829 PECOS PAC ID: 8628356904 Enrollment ID: I20161021001044 |
| Provider Name | Lisa M Sanko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356891790 PECOS PAC ID: 3971883919 Enrollment ID: I20161208000107 |
| Provider Name | Julia Didesiderio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548717192 PECOS PAC ID: 9537441993 Enrollment ID: I20170119000176 |
| Provider Name | Jenni Crossley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700393816 PECOS PAC ID: 3870853716 Enrollment ID: I20180214000774 |
| Provider Name | Chayna Hardy-reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508331778 PECOS PAC ID: 9133465057 Enrollment ID: I20190115001166 |
| Provider Name | Walettra Enoch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669941027 PECOS PAC ID: 2365875341 Enrollment ID: I20191205000197 |
| Provider Name | Tammy L Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639701428 PECOS PAC ID: 9739343690 Enrollment ID: I20200717001923 |
| Provider Name | Monifa Thelwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629734298 PECOS PAC ID: 7113227133 Enrollment ID: I20220131000669 |
| Provider Name | Ana Hubert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528370897 PECOS PAC ID: 6406080613 Enrollment ID: I20220224001953 |
| Provider Name | Jessica Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821675158 PECOS PAC ID: 5395145593 Enrollment ID: I20221014000309 |
| Provider Name | Juliana Hagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215656509 PECOS PAC ID: 7618343021 Enrollment ID: I20221026000094 |
| Provider Name | Carissa M Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821307646 PECOS PAC ID: 2264627132 Enrollment ID: I20230216002526 |
| Provider Name | Mariama Hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518946763 PECOS PAC ID: 8628033156 Enrollment ID: I20230518002466 |
| Provider Name | Marie Perkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356686059 PECOS PAC ID: 9931340908 Enrollment ID: I20230606000811 |
| Provider Name | Akosua Neferteti Obeng-aduasare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598311896 PECOS PAC ID: 7911238571 Enrollment ID: I20230725004046 |
| Provider Name | Ellen Brennan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821729039 PECOS PAC ID: 6305229741 Enrollment ID: I20231004001364 |
| Provider Name | Arianna Hope Sanborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225508203 PECOS PAC ID: 6709123722 Enrollment ID: I20231204001164 |
| Provider Name | Prisca Okwara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942919667 PECOS PAC ID: 4789054529 Enrollment ID: I20231222001065 |
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