| Eastern Pennsylvania Physician Alliance Llc | |
|
4641 E Roosevelt Blvd Philadelphia PA 19124-2343 | |
| (610) 382-4943 | |
| Not Available |
| Full Name | Eastern Pennsylvania Physician Alliance Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4641 E Roosevelt Blvd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Todd Evans (VP) |
| Authorized Official Contact | 6103824943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Pennsylvania Physician Alliance Llc 367 S Gulph Rd King Of Prussia PA 19406-3121 Ph: () - | Eastern Pennsylvania Physician Alliance Llc 4641 E Roosevelt Blvd Philadelphia PA 19124-2343 Ph: (610) 382-4943 |
| NPI Number | 1902440621 |
|---|---|
| Provider Enumeration Date | 11/06/2019 |
| Last Update Date | 11/06/2019 |
| Medicare PECOS PAC ID | 8325478662 |
|---|---|
| Medicare Enrollment ID | O20200428001935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902440621 | NPI | - | NPPES |
| PENDING | Medicaid | PA |
| Provider Name | Mitchell Rober Kho |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891836862 PECOS PAC ID: 1456253822 Enrollment ID: I20040126000162 |
| Provider Name | Jonathan G. Shack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629066626 PECOS PAC ID: 5092608265 Enrollment ID: I20040203000756 |
| Provider Name | Kem Yenal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215913868 PECOS PAC ID: 5890683932 Enrollment ID: I20040309001057 |
| Provider Name | Arif Husain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043276918 PECOS PAC ID: 5799676615 Enrollment ID: I20040322000866 |
| Provider Name | Chad M Lauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699703694 PECOS PAC ID: 3072506138 Enrollment ID: I20040405001386 |
| Provider Name | Ronald D Mcfadden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285718734 PECOS PAC ID: 6002809191 Enrollment ID: I20040405001605 |
| Provider Name | Kenneth Michael Levy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457319550 PECOS PAC ID: 3870587942 Enrollment ID: I20040412001245 |
| Provider Name | Anil K Rai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306830658 PECOS PAC ID: 3375537962 Enrollment ID: I20040414001591 |
| Provider Name | Mahrukh S Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467426247 PECOS PAC ID: 6901891407 Enrollment ID: I20040415000388 |
| Provider Name | Silvia Gratz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134161938 PECOS PAC ID: 9335139815 Enrollment ID: I20040517000263 |
| Provider Name | Kambeze B Etemad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841312196 PECOS PAC ID: 9931170248 Enrollment ID: I20040802000922 |
| Provider Name | Darren F Piechota |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205995552 PECOS PAC ID: 8426037847 Enrollment ID: I20040901000428 |
| Provider Name | Jagruti Amin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306945852 PECOS PAC ID: 1456312370 Enrollment ID: I20041025000327 |
| Provider Name | John F Lines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487607834 PECOS PAC ID: 2860453479 Enrollment ID: I20041026000575 |
| Provider Name | Andrew C Simonson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396845806 PECOS PAC ID: 2365404969 Enrollment ID: I20041027000110 |
| Provider Name | Evan Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891895322 PECOS PAC ID: 2961464581 Enrollment ID: I20041027000293 |
| Provider Name | Robert Kovar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366542862 PECOS PAC ID: 5092777623 Enrollment ID: I20041027000345 |
| Provider Name | Lihui Tang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447279955 PECOS PAC ID: 7315902004 Enrollment ID: I20041122000903 |
| Provider Name | Raghava Ghosala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639121270 PECOS PAC ID: 4082679790 Enrollment ID: I20041122001029 |
| Provider Name | Timothy Scott Peters Strickland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467523159 PECOS PAC ID: 2668438904 Enrollment ID: I20041208000296 |
| Provider Name | Hack R Chung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144394859 PECOS PAC ID: 0749248052 Enrollment ID: I20050103000475 |
| Provider Name | John P Leichner |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1225072192 PECOS PAC ID: 2567414832 Enrollment ID: I20050215000417 |
| Provider Name | Hai C Tsao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447226527 PECOS PAC ID: 2466491337 Enrollment ID: I20050429000319 |
| Provider Name | Abdulbari K Farooqi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093838286 PECOS PAC ID: 3779500939 Enrollment ID: I20051027000056 |
| Provider Name | Chand P Nair |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164453775 PECOS PAC ID: 0345269973 Enrollment ID: I20051114000423 |
| Provider Name | Uchenna Cosmas Uzoukwu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750359964 PECOS PAC ID: 9335162023 Enrollment ID: I20060110000279 |
| Provider Name | Abayomi O Ige |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184620130 PECOS PAC ID: 4183648967 Enrollment ID: I20060119000422 |
| Provider Name | Michael D Lance |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073655304 PECOS PAC ID: 9335163765 Enrollment ID: I20060126000878 |
| Provider Name | Chaudhry M Hassan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013957091 PECOS PAC ID: 6103831888 Enrollment ID: I20060216000356 |
| Provider Name | Pamela A. London |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750421962 PECOS PAC ID: 0244248011 Enrollment ID: I20060405000413 |
| Provider Name | Mushtaq Jameel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487605176 PECOS PAC ID: 2062416894 Enrollment ID: I20060908000149 |
| Provider Name | Daniela Krausz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922113281 PECOS PAC ID: 8022019041 Enrollment ID: I20070118000026 |
| Provider Name | Karriem Latett Salaam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114032786 PECOS PAC ID: 0547262537 Enrollment ID: I20070205000010 |
| Provider Name | Sarah N Gatumu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750489845 PECOS PAC ID: 1951303833 Enrollment ID: I20070206000197 |
| Provider Name | Johar A Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558432393 PECOS PAC ID: 4981708690 Enrollment ID: I20070404000455 |
| Provider Name | Mohamado Musthaq |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831115559 PECOS PAC ID: 0749386209 Enrollment ID: I20070501000171 |
| Provider Name | Paul A Ballas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033256235 PECOS PAC ID: 6709982614 Enrollment ID: I20070509000080 |
| Provider Name | Indranil Chakrabarti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457302143 PECOS PAC ID: 7810093747 Enrollment ID: I20070509000246 |
| Provider Name | Nasifa Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215074489 PECOS PAC ID: 4587760459 Enrollment ID: I20070509000609 |
| Provider Name | Ramesh Koneru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184650475 PECOS PAC ID: 8123125242 Enrollment ID: I20070523000629 |
| Provider Name | Karen L Tempest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891705752 PECOS PAC ID: 8729186481 Enrollment ID: I20070605000234 |
| Provider Name | Charles T Mcglynn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467574640 PECOS PAC ID: 4486755618 Enrollment ID: I20070718000444 |
| Provider Name | Venkat P Chakkaravarthi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285831693 PECOS PAC ID: 2961593926 Enrollment ID: I20070806000091 |
| Provider Name | Sachin Mehta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295926194 PECOS PAC ID: 2163516469 Enrollment ID: I20070918000143 |
| Provider Name | Hani S Zaki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750335519 PECOS PAC ID: 1153411301 Enrollment ID: I20071212000412 |
| Provider Name | Tasneem Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215094685 PECOS PAC ID: 3870674682 Enrollment ID: I20080118000090 |
| Provider Name | Panduranga Venkataramana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891815775 PECOS PAC ID: 6002995438 Enrollment ID: I20080509000202 |
| Provider Name | Christopher Squillaro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023192283 PECOS PAC ID: 2365513496 Enrollment ID: I20080618000198 |
| Provider Name | Syed Z Manzoor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194928952 PECOS PAC ID: 9032282272 Enrollment ID: I20080721000521 |
| Provider Name | Fauzia G Sheikh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518059724 PECOS PAC ID: 6608936778 Enrollment ID: I20081119000257 |
| Provider Name | Izabella L Dyakovetsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073512927 PECOS PAC ID: 5193888790 Enrollment ID: I20090108000041 |
| Provider Name | Chala Sargent |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437281318 PECOS PAC ID: 8123183886 Enrollment ID: I20090212000023 |
| Provider Name | Olayinka M Ajayi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215185103 PECOS PAC ID: 9032273347 Enrollment ID: I20090225000591 |
| Provider Name | Mustafa Kaleem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578724258 PECOS PAC ID: 6608929583 Enrollment ID: I20090727000118 |
| Provider Name | Nikkisha P Mccrea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144384041 PECOS PAC ID: 6800940099 Enrollment ID: I20090824000077 |
| Provider Name | Brigid Bautista |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770639080 PECOS PAC ID: 8325032295 Enrollment ID: I20100323000161 |
| Provider Name | Tina L Reiter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336140755 PECOS PAC ID: 3274661616 Enrollment ID: I20100506000007 |
| Provider Name | Shawn L Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992709844 PECOS PAC ID: 5395875959 Enrollment ID: I20100609000396 |
| Provider Name | Lesley Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063581742 PECOS PAC ID: 1658401955 Enrollment ID: I20100614000160 |
| Provider Name | Cathy S Shadle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932146917 PECOS PAC ID: 0648301598 Enrollment ID: I20100622000220 |
| Provider Name | Baogang Xue |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740463470 PECOS PAC ID: 3476684598 Enrollment ID: I20100706000214 |
| Provider Name | Priyankar Sarkar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215149661 PECOS PAC ID: 8729110705 Enrollment ID: I20100712000283 |
| Provider Name | Edward Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013009216 PECOS PAC ID: 4082806849 Enrollment ID: I20101012000516 |
| Provider Name | Frank J Hamlett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659377760 PECOS PAC ID: 4688862956 Enrollment ID: I20101230000776 |
| Provider Name | Roseann Theresa Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245532878 PECOS PAC ID: 9739363979 Enrollment ID: I20110412000759 |
| Provider Name | Lee D Silverman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760498927 PECOS PAC ID: 1658556089 Enrollment ID: I20110429000330 |
| Provider Name | Neil R Cohn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699784777 PECOS PAC ID: 1456536887 Enrollment ID: I20110429000350 |
| Provider Name | James Boote Congdon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588764153 PECOS PAC ID: 2466638689 Enrollment ID: I20110523000734 |
| Provider Name | Thambipillai Sureshkumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134211253 PECOS PAC ID: 6002094059 Enrollment ID: I20110622000696 |
| Provider Name | Stephen A. Prayson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265580468 PECOS PAC ID: 8123205523 Enrollment ID: I20110623000452 |
| Provider Name | Raghavendra Siragavarapu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154582377 PECOS PAC ID: 2062680705 Enrollment ID: I20110722000458 |
| Provider Name | Dele Omije |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568607471 PECOS PAC ID: 5597934166 Enrollment ID: I20111031000205 |
| Provider Name | Jeffrey M. Moll |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386972040 PECOS PAC ID: 1355508177 Enrollment ID: I20120207000430 |
| Provider Name | Huma Mahmood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538320130 PECOS PAC ID: 8123283249 Enrollment ID: I20120622000281 |
| Provider Name | Frances Aledo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912110859 PECOS PAC ID: 1557400058 Enrollment ID: I20130109000141 |
| Provider Name | Catherine Gayle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528039146 PECOS PAC ID: 7810916046 Enrollment ID: I20130705000134 |
| Provider Name | James J Yi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699948562 PECOS PAC ID: 9133361199 Enrollment ID: I20130805000404 |
| Provider Name | Ebere A Anokwuru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619255825 PECOS PAC ID: 7315189123 Enrollment ID: I20130807000589 |
| Provider Name | Ashley E Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962844985 PECOS PAC ID: 3678716032 Enrollment ID: I20130904000359 |
| Provider Name | Marina Shainsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023273158 PECOS PAC ID: 8921242082 Enrollment ID: I20130912000042 |
| Provider Name | Sultana Begum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457304909 PECOS PAC ID: 9739127572 Enrollment ID: I20131101000331 |
| Provider Name | Jaspreet Singh Bains |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588003826 PECOS PAC ID: 8426284985 Enrollment ID: I20131112001041 |
| Provider Name | Mayank Gupta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669612032 PECOS PAC ID: 9133355811 Enrollment ID: I20131203000046 |
| Provider Name | Evelyne B Nyangara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427302520 PECOS PAC ID: 1456587138 Enrollment ID: I20131203000213 |
| Provider Name | Olumide O Oluwabusi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972733061 PECOS PAC ID: 2466680681 Enrollment ID: I20140116000148 |
| Provider Name | David M Danish |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992903512 PECOS PAC ID: 0749413680 Enrollment ID: I20140430001771 |
| Provider Name | Stephen K Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235247180 PECOS PAC ID: 8325064629 Enrollment ID: I20140812001424 |
| Provider Name | Lavenia Fain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649697202 PECOS PAC ID: 6103047824 Enrollment ID: I20141022001615 |
| Provider Name | Santiago Alberto Almanzar Disla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770926750 PECOS PAC ID: 4880838697 Enrollment ID: I20141113000448 |
| Provider Name | Shobha Sem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336124452 PECOS PAC ID: 9032435904 Enrollment ID: I20150312000229 |
| Provider Name | David Lemonte Gaines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992140800 PECOS PAC ID: 0446485197 Enrollment ID: I20150415001384 |
| Provider Name | Sheila Judge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851491344 PECOS PAC ID: 7214257757 Enrollment ID: I20150522001326 |
| Provider Name | Rochelle B Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871977017 PECOS PAC ID: 0244545291 Enrollment ID: I20150819008820 |
| Provider Name | Heewon Jeong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730555814 PECOS PAC ID: 6305149915 Enrollment ID: I20160114001315 |
| Provider Name | Fahad Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053622969 PECOS PAC ID: 8628396942 Enrollment ID: I20160208001247 |
| Provider Name | Adrienne N Lamb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538450820 PECOS PAC ID: 7315241544 Enrollment ID: I20160209002345 |
| Provider Name | Liju Mathew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477948578 PECOS PAC ID: 1951606714 Enrollment ID: I20160217000057 |
| Provider Name | Ana Maria Sarasti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134159155 PECOS PAC ID: 4486640307 Enrollment ID: I20160303000891 |
| Provider Name | Phuong H Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336505064 PECOS PAC ID: 3274832266 Enrollment ID: I20160426000185 |
| Provider Name | Chijioke Nnanna Egbujo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164601548 PECOS PAC ID: 9830484005 Enrollment ID: I20160826001276 |
| Provider Name | Sherry A Nykiel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932236361 PECOS PAC ID: 2062536436 Enrollment ID: I20161003000505 |
| Provider Name | Mitali Patnaik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457606402 PECOS PAC ID: 3375831357 Enrollment ID: I20161006000893 |
| Provider Name | Cristhi A Wilson Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073988374 PECOS PAC ID: 5799073292 Enrollment ID: I20161017001760 |
| Provider Name | Charles C Stanfa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861832156 PECOS PAC ID: 3072891258 Enrollment ID: I20161021001118 |
| Provider Name | Heather Madsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881149474 PECOS PAC ID: 5698057966 Enrollment ID: I20170120001962 |
| Provider Name | Ashley Lauren Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245781285 PECOS PAC ID: 3476835299 Enrollment ID: I20170131000601 |
| Provider Name | Cyntrell Crawford |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710242904 PECOS PAC ID: 0648553321 Enrollment ID: I20170202001685 |
| Provider Name | Juliet J Muzere |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992095285 PECOS PAC ID: 3678856200 Enrollment ID: I20170206001970 |
| Provider Name | Gerald Mehalick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689791097 PECOS PAC ID: 9234221813 Enrollment ID: I20170225000277 |
| Provider Name | Randy J Su |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891137857 PECOS PAC ID: 4284910662 Enrollment ID: I20170419002505 |
| Provider Name | Paula M Diorio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083155204 PECOS PAC ID: 3476820879 Enrollment ID: I20170606000358 |
| Provider Name | Denka Marah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669916961 PECOS PAC ID: 2961773783 Enrollment ID: I20170811001885 |
| Provider Name | Paige Mclaughlin |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1629390562 PECOS PAC ID: 5395054233 Enrollment ID: I20170905001944 |
| Provider Name | Oluwadamilola Fowowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760838783 PECOS PAC ID: 5890077184 Enrollment ID: I20171027001804 |
| Provider Name | David B Roat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629137278 PECOS PAC ID: 6002881422 Enrollment ID: I20171129000199 |
| Provider Name | Charles A Wisniewski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770997587 PECOS PAC ID: 8123382975 Enrollment ID: I20180503001229 |
| Provider Name | Alexandra Rowan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235542721 PECOS PAC ID: 5193070472 Enrollment ID: I20180709002559 |
| Provider Name | Tiy L Adams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912210535 PECOS PAC ID: 6305192196 Enrollment ID: I20180710000511 |
| Provider Name | Jerry Michael Sayers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801143912 PECOS PAC ID: 4587911557 Enrollment ID: I20180723000202 |
| Provider Name | Muhammad A Naz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780977421 PECOS PAC ID: 2466627740 Enrollment ID: I20181005000275 |
| Provider Name | Leon E Cushenberry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053669218 PECOS PAC ID: 1658660345 Enrollment ID: I20181012000941 |
| Provider Name | Kathryn J Newton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326457896 PECOS PAC ID: 7810240785 Enrollment ID: I20181023000189 |
| Provider Name | Justin Jye Chou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154611150 PECOS PAC ID: 9638487630 Enrollment ID: I20181029002300 |
| Provider Name | Prasad R Joshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881009686 PECOS PAC ID: 2860730777 Enrollment ID: I20190218002752 |
| Provider Name | Sajeeb Adhikary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700204609 PECOS PAC ID: 4183963630 Enrollment ID: I20190228001907 |
| Provider Name | Lindsey S Harvilla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750764361 PECOS PAC ID: 4486994803 Enrollment ID: I20190321002917 |
| Provider Name | Matthew C Parker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649620089 PECOS PAC ID: 6507107182 Enrollment ID: I20190409000265 |
| Provider Name | Flora P Chhay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326511015 PECOS PAC ID: 6608118278 Enrollment ID: I20190501000083 |
| Provider Name | Kenneth V Master |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659317949 PECOS PAC ID: 0143203083 Enrollment ID: I20190613001696 |
| Provider Name | Michael Esang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780061846 PECOS PAC ID: 8224375696 Enrollment ID: I20190829000359 |
| Provider Name | Ashley Shepard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194110197 PECOS PAC ID: 3577867092 Enrollment ID: I20190925000027 |
| Provider Name | Madhusmita Sahoo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912499377 PECOS PAC ID: 2567793383 Enrollment ID: I20191009001875 |
| Provider Name | Bhanu Srigiriraju |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881076297 PECOS PAC ID: 8022349869 Enrollment ID: I20191009002781 |
| Provider Name | Kaushik Roy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205234754 PECOS PAC ID: 5890057210 Enrollment ID: I20191015001756 |
| Provider Name | Ahmed Fayed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407240344 PECOS PAC ID: 5294167177 Enrollment ID: I20191114001009 |
| Provider Name | Sanju V George |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659786911 PECOS PAC ID: 3779916432 Enrollment ID: I20191211000028 |
| Provider Name | Adesanmi A Ojo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588079602 PECOS PAC ID: 4082965306 Enrollment ID: I20191211000163 |
| Provider Name | Panya Asabi Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124681507 PECOS PAC ID: 8921433533 Enrollment ID: I20200108001770 |
| Provider Name | Shameem Momin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376804955 PECOS PAC ID: 0042454787 Enrollment ID: I20200130000833 |
| Provider Name | Dina A Greco |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447690920 PECOS PAC ID: 5092141085 Enrollment ID: I20200211002277 |
| Provider Name | Colleen Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326689753 PECOS PAC ID: 4385075860 Enrollment ID: I20200518000953 |
| Provider Name | Mutiat L Ajibade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407480155 PECOS PAC ID: 9032532437 Enrollment ID: I20200701002602 |
| Provider Name | Muhammad Saeed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528161528 PECOS PAC ID: 7517938764 Enrollment ID: I20200709002596 |
| Provider Name | Orlando R Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477676807 PECOS PAC ID: 7719172246 Enrollment ID: I20201118001614 |
| Provider Name | Amanda Petaccio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720666571 PECOS PAC ID: 8123436078 Enrollment ID: I20210414002215 |
| Provider Name | Konstantin Tetelman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447836457 PECOS PAC ID: 8224446448 Enrollment ID: I20210427002954 |
| Provider Name | Paul Anthony Cristofano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336596998 PECOS PAC ID: 9537590351 Enrollment ID: I20210430001914 |
| Provider Name | Zakiyyah Muhsin Fall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720612914 PECOS PAC ID: 0941619589 Enrollment ID: I20210511001671 |
| Provider Name | Joshua M Nickerson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386091130 PECOS PAC ID: 1951726207 Enrollment ID: I20210525000696 |
| Provider Name | Sarita Oyeamarah Metzger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972033629 PECOS PAC ID: 5698183606 Enrollment ID: I20210526002381 |
| Provider Name | Jenny L Lugo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417478546 PECOS PAC ID: 9032488929 Enrollment ID: I20210625000914 |
| Provider Name | Salman N Salaria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891157699 PECOS PAC ID: 7911234158 Enrollment ID: I20210811000111 |
| Provider Name | Faith Pettyjohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508431800 PECOS PAC ID: 3476958075 Enrollment ID: I20210819002460 |
| Provider Name | Trevor Henry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235659277 PECOS PAC ID: 3870863137 Enrollment ID: I20210821000316 |
| Provider Name | Andrea Willoughby Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992293419 PECOS PAC ID: 6103216395 Enrollment ID: I20211201003243 |
| Provider Name | Kenny S Hirschi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548611494 PECOS PAC ID: 7416349881 Enrollment ID: I20220114000355 |
| Provider Name | Munachim Uyanwune |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710203591 PECOS PAC ID: 8022236967 Enrollment ID: I20220127000023 |
| Provider Name | Jumi Park |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144973850 PECOS PAC ID: 7517350747 Enrollment ID: I20220210000213 |
| Provider Name | Sundeep Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295487452 PECOS PAC ID: 2062805005 Enrollment ID: I20220215001428 |
| Provider Name | William A. Vanhorn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588620058 PECOS PAC ID: 9830153881 Enrollment ID: I20220324000561 |
| Provider Name | Erik Auker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508426404 PECOS PAC ID: 1759616113 Enrollment ID: I20220405003081 |
| Provider Name | Daniel Wolff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528713088 PECOS PAC ID: 9436546678 Enrollment ID: I20220418002606 |
| Provider Name | Shiara Kaye Rendon Peart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851062475 PECOS PAC ID: 1557758992 Enrollment ID: I20220503001914 |
| Provider Name | Ninaben Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699417857 PECOS PAC ID: 1951788918 Enrollment ID: I20220512000358 |
| Provider Name | Shakeria L Gaither |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710630710 PECOS PAC ID: 5597144972 Enrollment ID: I20220614003284 |
| Provider Name | Olivia Weigold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841882933 PECOS PAC ID: 1456768902 Enrollment ID: I20220715002493 |
| Provider Name | Sabeen S Haque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609281575 PECOS PAC ID: 9032403001 Enrollment ID: I20220818000185 |
| Provider Name | Emmanuel K Nsiah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396237202 PECOS PAC ID: 2062898851 Enrollment ID: I20221002000016 |
| Provider Name | Stephen Veterano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821583683 PECOS PAC ID: 2365844784 Enrollment ID: I20221006001257 |
| Provider Name | Diyor Suyumov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538789516 PECOS PAC ID: 6800226390 Enrollment ID: I20221006002356 |
| Provider Name | Andre R Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639810732 PECOS PAC ID: 5597131003 Enrollment ID: I20221024002181 |
| Provider Name | Robert M Simms |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336281898 PECOS PAC ID: 9436288156 Enrollment ID: I20221102003128 |
| Provider Name | Shannon Nicosia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114539269 PECOS PAC ID: 8426464298 Enrollment ID: I20221114002641 |
| Provider Name | Jerica Gerena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487274148 PECOS PAC ID: 7416388392 Enrollment ID: I20221121002490 |
| Provider Name | Erin Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467179705 PECOS PAC ID: 3173995818 Enrollment ID: I20230207001440 |
| Provider Name | Belinda S Early |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720675408 PECOS PAC ID: 4789092982 Enrollment ID: I20230222001770 |
| Provider Name | Flor Mizrahi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790995793 PECOS PAC ID: 1254665888 Enrollment ID: I20230511003149 |
| Provider Name | Verra Mubele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720341233 PECOS PAC ID: 6709245533 Enrollment ID: I20230711002344 |
| Provider Name | Franklyn Boothe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215433297 PECOS PAC ID: 4587910419 Enrollment ID: I20230726001237 |
| Provider Name | Brijae Chavarria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316408271 PECOS PAC ID: 2163885831 Enrollment ID: I20230828003955 |
| Provider Name | Georges Theodule |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740967215 PECOS PAC ID: 2769830678 Enrollment ID: I20231201002102 |
| Provider Name | Mary Hulse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427837293 PECOS PAC ID: 5991154767 Enrollment ID: I20231206001331 |
| Provider Name | Dustin Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518549328 PECOS PAC ID: 2961811492 Enrollment ID: I20231218004252 |
| Provider Name | Chris Gauthier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083281141 PECOS PAC ID: 6709286701 Enrollment ID: I20240129001474 |
| Provider Name | Dasylia Willoughby |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689299083 PECOS PAC ID: 9032553961 Enrollment ID: I20240220001262 |
| Provider Name | Uchenna Joseph Ekeabu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467225888 PECOS PAC ID: 8628414232 Enrollment ID: I20240306000247 |
| Provider Name | Iris W Maldonado Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568110351 PECOS PAC ID: 1052793080 Enrollment ID: I20240326002979 |
Solis Physicians Network Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5800 Ridge Ave, Philadelphia, PA 19128 Phone: 215-487-4692 Fax: 215-487-4274 | |
Apm Mental Health Psychiatric Outpatient Clinics Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2921 N 5th St, Philadelphia, PA 19133 Phone: 215-259-3373 Fax: 267-329-9728 | |
University Of Pennsylvania Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3400 Civic Center Blvd, 2 South Pavilion, Philadelphia, PA 19104 Phone: 215-614-1828 | |
The Phil.consultation Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 S 16th St, Philadelphia, PA 19102 Phone: 215-732-8244 Fax: 215-732-8454 | |
Immanuel Care Support Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6641 Dorel St, Philadelphia, PA 19142 Phone: 267-403-8313 | |
Npsyt Psychological Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6327 Burbridge St, Philadelphia, PA 19144 Phone: 215-991-9066 Fax: 215-991-9062 | |
Menergy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7500 Germantown Ave, New Covenant Campus, Elders Hall, Suite 5, Philadelphia, PA 19119 Phone: 215-242-2235 |