| Wings Of Hope Medical Services, Llc | |
|
11022 N 28th Dr Ste 205 Phoenix AZ 85029-5635 | |
| (602) 971-0304 | |
| (602) 971-0305 |
| Full Name | Wings Of Hope Medical Services, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11022 N 28th Dr Ste 205, Phoenix, Arizona |
| Authorized Official Name and Position | Angela Katz (CEO/ADMINISTRATOR) |
| Authorized Official Contact | 6029710304 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wings Of Hope Medical Services, Llc 11022 N 28th Dr Ste 205 Phoenix AZ 85029-5635 Ph: (602) 971-0304 | Wings Of Hope Medical Services, Llc 11022 N 28th Dr Ste 205 Phoenix AZ 85029-5635 Ph: (602) 971-0304 |
| NPI Number | 1003282278 |
|---|---|
| Provider Enumeration Date | 08/11/2015 |
| Last Update Date | 04/24/2019 |
| Medicare PECOS PAC ID | 7719277169 |
|---|---|
| Medicare Enrollment ID | O20160526001261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003282278 | NPI | - | NPPES |
| Provider Name | Ilya Katz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104026319 PECOS PAC ID: 1951469220 Enrollment ID: I20090813000745 |
| Provider Name | Keqiang Shen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154713048 PECOS PAC ID: 4082933742 Enrollment ID: I20150430000252 |
| Provider Name | Malar Kuppan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295216190 PECOS PAC ID: 1456695998 Enrollment ID: I20181210002790 |
| Provider Name | Karie M Pietrykowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356828826 PECOS PAC ID: 5193064970 Enrollment ID: I20210322002128 |
| Provider Name | Alexandra Caienar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922763754 PECOS PAC ID: 0042602153 Enrollment ID: I20220124001082 |
| Provider Name | Liliana Santellano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588381214 PECOS PAC ID: 2163894411 Enrollment ID: I20230214001946 |
| Provider Name | Adam K Zamora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548032006 PECOS PAC ID: 5597113191 Enrollment ID: I20231120003214 |
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