Brenda R Van Fossen, MD | |
7375 Oswego Rd, Liverpool, NY 13090-3717 | |
(315) 291-0064 | |
(315) 291-0065 |
Full Name | Brenda R Van Fossen |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 7375 Oswego Rd, Liverpool, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073522587 | NPI | - | NPPES |
0191866 | Other | WA | STATE L&I |
8409245 | Medicaid | WA | |
8939525 | Other | WA | STATE CRIME VICTIMS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD00043720 (Washington) | Secondary |
208000000X | Pediatrics | 291334 (New York) | Primary |
Entity Name | Multicare Health System |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497766638 PECOS PAC ID: 7719899897 Enrollment ID: O20031105000760 |
Mailing Address | Practice Location Address |
---|---|
Brenda R Van Fossen, MD Po Box 500, Ellicottville, NY 14731-0500 Ph: (716) 699-9032 | Brenda R Van Fossen, MD 7375 Oswego Rd, Liverpool, NY 13090-3717 Ph: (315) 291-0064 |
Meghan Dambach, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4811 Buckley Rd, Liverpool, NY 13088 Phone: 315-457-9966 | |
Nicole Autumn Mirjafari, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5100 W Taft Rd Ste 1b, Liverpool, NY 13088 Phone: 239-343-9888 Fax: 239-303-0714 | |
Mrs. Maritza Alvarado, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4811 Buckley Rd, Liverpool, NY 13088 Phone: 315-457-9966 Fax: 315-457-9854 | |
Mrs. Angelle M Cresswell, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Garnoch Ct, Liverpool, NY 13090 Phone: 315-457-0872 | |
Dr. Mary V Green, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4811 Buckley Rd, Liverpool, NY 13088 Phone: 315-457-9966 Fax: 315-457-9854 | |
Fozia Bakshi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4811 Buckley Rd, Liverpool, NY 13088 Phone: 315-457-9966 Fax: 315-379-4900 |