| Corelife | |
|
3601 Chichester Ave Unit 101 Upper Chichester PA 19061-3149 | |
| (484) 768-6762 | |
| (855) 772-4748 |
| Full Name | Corelife |
|---|---|
| Speciality | Family Medicine |
| Location | 3601 Chichester Ave Unit 101, Upper Chichester, Pennsylvania |
| Authorized Official Name and Position | Raymond Joseph Kostkowski (CEO) |
| Authorized Official Contact | 4109910044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corelife 1111 Benfield Blvd Ste 250 Millersville MD 21108-3005 Ph: (800) 905-3261 | Corelife 3601 Chichester Ave Unit 101 Upper Chichester PA 19061-3149 Ph: (484) 768-6762 |
| NPI Number | 1326681214 |
|---|---|
| Provider Enumeration Date | 10/23/2019 |
| Last Update Date | 10/25/2021 |
| Certification Date | 10/25/2021 |
| Medicare PECOS PAC ID | 3779917109 |
|---|---|
| Medicare Enrollment ID | O20191218001091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326681214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael T Parke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033105382 PECOS PAC ID: 3375548043 Enrollment ID: I20061129000116 |
| Provider Name | William Charles Ware |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497716849 PECOS PAC ID: 8628256252 Enrollment ID: I20110629000360 |
| Provider Name | Ritaann Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972960748 PECOS PAC ID: 5395044382 Enrollment ID: I20160426000405 |
| Provider Name | Stephanie Malik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124536438 PECOS PAC ID: 3678836020 Enrollment ID: I20180417001544 |
| Provider Name | Polina V Kozlowski Sannik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932565405 PECOS PAC ID: 1658608963 Enrollment ID: I20190809000019 |
| Provider Name | Sarah Hubert |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699308056 PECOS PAC ID: 3274961289 Enrollment ID: I20200324003611 |
| Provider Name | Mary Holt-caputo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477187722 PECOS PAC ID: 7911335930 Enrollment ID: I20200325000176 |
| Provider Name | Jessica L Delgiorno |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487272605 PECOS PAC ID: 6103241542 Enrollment ID: I20200803001484 |
| Provider Name | Lori Economos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205970100 PECOS PAC ID: 8426395310 Enrollment ID: I20210105000619 |
| Provider Name | Kristyn Hydock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427681824 PECOS PAC ID: 1052725769 Enrollment ID: I20210120002157 |
| Provider Name | Allison Kolankiewicz |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1689253825 PECOS PAC ID: 9830599117 Enrollment ID: I20210608001052 |
| Provider Name | Melissa Fleck |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1336816586 PECOS PAC ID: 4880092832 Enrollment ID: I20211006001260 |
| Provider Name | Daniel R Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154917409 PECOS PAC ID: 7315336278 Enrollment ID: I20211115001416 |
| Provider Name | Chintan A Pancholi-parekh |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194943050 PECOS PAC ID: 9335533769 Enrollment ID: I20220301002580 |
| Provider Name | Shiara Kaye Rendon Peart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851062475 PECOS PAC ID: 1557758992 Enrollment ID: I20220503001914 |
Freetolive Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4362 Trophy Dr, Upper Chichester, PA 19061 Phone: 484-496-4694 |