| Aldad Medical Pc | |
|
263 Tresser Blvd Fl 9 Stamford CT 06901-3236 | |
| (516) 505-7200 | |
| Not Available |
| Full Name | Aldad Medical Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 263 Tresser Blvd Fl 9, Stamford, Connecticut |
| Authorized Official Name and Position | Tamir Aldad (CEO) |
| Authorized Official Contact | 5165057200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aldad Medical Pc 510 Hempstead Tpke Rm 203 West Hempstead NY 11552-1152 Ph: (516) 505-7200 | Aldad Medical Pc 263 Tresser Blvd Fl 9 Stamford CT 06901-3236 Ph: (516) 505-7200 |
| NPI Number | 1750046512 |
|---|---|
| Provider Enumeration Date | 11/05/2021 |
| Last Update Date | 03/28/2023 |
| Certification Date | 03/28/2023 |
| Medicare PECOS PAC ID | 5395152201 |
|---|---|
| Medicare Enrollment ID | O20211221000940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750046512 | NPI | - | NPPES |
| 64175 | Other | CT | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Thomas Martin Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023274495 PECOS PAC ID: 7113148503 Enrollment ID: I20141029000079 |
| Provider Name | Wilmot Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003121674 PECOS PAC ID: 7315088945 Enrollment ID: I20170810001191 |
| Provider Name | Tamir Aldad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407207830 PECOS PAC ID: 3577817899 Enrollment ID: I20211221001039 |
| Provider Name | Dedra Terry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184089369 PECOS PAC ID: 3476842444 Enrollment ID: I20220518000557 |
| Provider Name | April Guilliams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184285926 PECOS PAC ID: 8527395532 Enrollment ID: I20220802003269 |
| Provider Name | Michael Destefano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407200116 PECOS PAC ID: 7214355130 Enrollment ID: I20231019002875 |
| Provider Name | Jeffrey Chang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942658216 PECOS PAC ID: 2264855303 Enrollment ID: I20231214003114 |
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