Kaleen D Puccetti, | |
10945 N Port Washington Rd, Thiensville, WI 53092-5078 | |
(262) 292-3151 | |
Not Available |
Full Name | Kaleen D Puccetti |
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Gender | Female |
Speciality | Radiology - Diagnostic Radiology |
Location | 10945 N Port Washington Rd, Thiensville, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831545094 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 69881 (Wisconsin) | Primary |
Entity Name | Wisconsin Radiology Specialists Sc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568446003 PECOS PAC ID: 2961314091 Enrollment ID: O20031105000585 |
Entity Name | The Medical College Of Wisconsin Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699720086 PECOS PAC ID: 2668384371 Enrollment ID: O20031120000259 |
Entity Name | Froedtert &the Medical College Of Wisconsin Community Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568787448 PECOS PAC ID: 3678760063 Enrollment ID: O20101210000699 |
Entity Name | Premier Radiology Wisconsin Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952951154 PECOS PAC ID: 9537595533 Enrollment ID: O20200211002818 |
Entity Name | Precision Radiology - Illinois Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265156640 PECOS PAC ID: 6305218298 Enrollment ID: O20230201002800 |
Mailing Address | Practice Location Address |
---|---|
Kaleen D Puccetti, Po Box 713121, Chicago, IL 60677-0321 Ph: (262) 292-3151 | Kaleen D Puccetti, 10945 N Port Washington Rd, Thiensville, WI 53092-5078 Ph: (262) 292-3151 |
Eric Wideburg, D.O. Radiology Medicare: Medicare Enrolled Practice Location: 10945 N Port Washington Rd Ste 201, Thiensville, WI 53092 Phone: 262-292-3151 Fax: 262-643-4707 | |
Jordan Alexander Kapke, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 10945 N Port Washington Rd Ste 201, Thiensville, WI 53092 Phone: 262-292-3151 |