Dr Thelma Barker Gaetano, MD | |
325 Meeting House Ln, Southampton, NY 11968-5087 | |
(631) 283-7733 | |
(631) 283-3183 |
Full Name | Dr Thelma Barker Gaetano |
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Gender | Female |
Speciality | Pediatrics |
Location | 325 Meeting House Ln, Southampton, 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 |
---|---|---|---|
1730325721 | NPI | - | NPPES |
3153555 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 35.088709 (Ohio) | Secondary |
208000000X | Pediatrics | 307332 (New York) | Primary |
Entity Name | Stony Brook Children's Service, University Faculty Practice Corporatio |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083660575 PECOS PAC ID: 8921993551 Enrollment ID: O20040220000822 |
Mailing Address | Practice Location Address |
---|---|
Dr Thelma Barker Gaetano, MD 500 Commack Rd Unit 206, Commack, NY 11725-5022 Ph: (631) 675-2125 | Dr Thelma Barker Gaetano, MD 325 Meeting House Ln, Southampton, NY 11968-5087 Ph: (631) 283-7733 |
Forough B Mokhtari, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5 Squiretown Road, South Hampton Pediatric, Southampton, NY 11946 Phone: 631-728-5300 Fax: 631-728-5360 | |
Mrs. Karen Lee, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 444 N Sea Rd, Southampton, NY 11968 Phone: 631-283-4843 Fax: 631-259-3850 | |
Kacey Johannah Pryzby, PNP Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 444 N Sea Rd, Southampton, NY 11968 Phone: 631-283-4843 | |
Dr. Nadine Persheff, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 444 N Sea Rd, Southampton, NY 11968 Phone: 631-283-4843 Fax: 631-614-7969 | |
Gerard P Mcloughlin, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 436 Hill St, Southampton, NY 11968 Phone: 631-283-8630 Fax: 631-283-8630 | |
Dr. Louis M Goldblum, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 325 Meeting House Ln, Southampton, NY 11968 Phone: 631-283-7733 |