Family Care Associates | |
702 Russell Ave Ste 100 Gaithersburg MD 20877-2605 | |
(301) 330-0006 | |
(301) 330-0444 |
Full Name | Family Care Associates |
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Speciality | Clinic/Center |
Location | 702 Russell Ave Ste 100, Gaithersburg, Maryland |
Authorized Official Name and Position | Gennady Vinokur (MANAGER) |
Authorized Official Contact | 3013300006 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Care Associates 702 Russell Ave Ste 100 Gaithersburg MD 20877-2605 Ph: (301) 330-0006 | Family Care Associates 702 Russell Ave Ste 100 Gaithersburg MD 20877-2605 Ph: (301) 330-0006 |
NPI Number | 1003151291 |
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Provider Enumeration Date | 11/29/2012 |
Last Update Date | 07/02/2020 |
Certification Date | 07/02/2020 |
Medicare PECOS PAC ID | 8325283229 |
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Medicare Enrollment ID | O20130326000017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003151291 | NPI | - | NPPES |
Provider Name | Anitha Kandaswamy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1528383445 PECOS PAC ID: 1850514191 Enrollment ID: I20140514000773 |
Provider Name | Memouna M Foudjou |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578967972 PECOS PAC ID: 1658695440 Enrollment ID: I20150128000400 |
Provider Name | Francis Ihejirika |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124797287 PECOS PAC ID: 6901297233 Enrollment ID: I20211222000069 |
Provider Name | Eboni Clipper |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1083063887 PECOS PAC ID: 0143694299 Enrollment ID: I20240229003944 |
Provider Name | Tracy Tsao |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1528620424 PECOS PAC ID: 2668812835 Enrollment ID: I20240506000031 |
Provider Name | Loretta Lukic |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1134427131 PECOS PAC ID: 1355886110 Enrollment ID: I20241014003953 |
Provider Name | Trac Nguyen |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1033842976 PECOS PAC ID: 7618412305 Enrollment ID: I20241018001245 |
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