| John T. Mather Memorial Hospital | |
|
75 N Country Rd Port Jefferson Station NY 11777-2119 | |
| (631) 473-1320 | |
| (631) 686-7972 |
| Full Name | John T. Mather Memorial Hospital |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 75 N Country Rd, Port Jefferson Station, New York |
| Authorized Official Name and Position | Joseph Wisnoski (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 6314731320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John T. Mather Memorial Hospital Po Box 6435 Brattleboro VT 05302-6435 Ph: (631) 473-1320 | John T. Mather Memorial Hospital 75 N Country Rd Port Jefferson Station NY 11777-2119 Ph: (631) 473-1320 |
| NPI Number | 1376642371 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 01/04/2023 |
| Certification Date | 01/04/2023 |
| Medicare PECOS PAC ID | 1254237753 |
|---|---|
| Medicare Enrollment ID | O20040316000754 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376642371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Thomas F Jan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1871685404 PECOS PAC ID: 8123931631 Enrollment ID: I20031111000215 |
| Provider Name | Michelle P Price |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629080478 PECOS PAC ID: 4385549120 Enrollment ID: I20031204000462 |
| Provider Name | Laureen A Diot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235191370 PECOS PAC ID: 5294726758 Enrollment ID: I20040521001307 |
| Provider Name | Genine M Schwinge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053492017 PECOS PAC ID: 2264419449 Enrollment ID: I20040706000880 |
| Provider Name | Theresa A Grimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912910910 PECOS PAC ID: 3870572738 Enrollment ID: I20040715000504 |
| Provider Name | Marilyn F Conner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316041528 PECOS PAC ID: 8527032895 Enrollment ID: I20040823000850 |
| Provider Name | Richard A Daly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639282783 PECOS PAC ID: 1456326271 Enrollment ID: I20040826000485 |
| Provider Name | Jacob D Sokol |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245221167 PECOS PAC ID: 6709847379 Enrollment ID: I20041026001071 |
| Provider Name | Mohammad A Bilal |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1669422572 PECOS PAC ID: 9335101682 Enrollment ID: I20041029000574 |
| Provider Name | Victoria Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255484788 PECOS PAC ID: 2860455995 Enrollment ID: I20041109000808 |
| Provider Name | John F Anderson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1740249580 PECOS PAC ID: 0749233906 Enrollment ID: I20050228000641 |
| Provider Name | Gloria Mccann Fortune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952447005 PECOS PAC ID: 3870548399 Enrollment ID: I20050317000664 |
| Provider Name | Susan S Emanuele |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902965163 PECOS PAC ID: 7416992482 Enrollment ID: I20050621001125 |
| Provider Name | Adam F Wos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144373960 PECOS PAC ID: 8729051024 Enrollment ID: I20050714000989 |
| Provider Name | Wilma S Lopez |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1306803317 PECOS PAC ID: 6901833755 Enrollment ID: I20050722000669 |
| Provider Name | Jennifer Doolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346339744 PECOS PAC ID: 1557398351 Enrollment ID: I20050723000127 |
| Provider Name | Gregg E Zimmerman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790766228 PECOS PAC ID: 0941232458 Enrollment ID: I20050906000829 |
| Provider Name | Miguel A Delgado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649237249 PECOS PAC ID: 7416980966 Enrollment ID: I20050914001295 |
| Provider Name | Harinder S Sawhney |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669518437 PECOS PAC ID: 9335167170 Enrollment ID: I20051109001115 |
| Provider Name | Joseph M Carrucciu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063424828 PECOS PAC ID: 4688671159 Enrollment ID: I20061025000403 |
| Provider Name | Mark H Auerbach |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285658666 PECOS PAC ID: 2466453865 Enrollment ID: I20070129000183 |
| Provider Name | Margaret M Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376652461 PECOS PAC ID: 3870695471 Enrollment ID: I20070228000604 |
| Provider Name | Bo Chao |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659462695 PECOS PAC ID: 7012019623 Enrollment ID: I20070228000718 |
| Provider Name | Kristina L Demarco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407853526 PECOS PAC ID: 0042316523 Enrollment ID: I20070430000195 |
| Provider Name | Mikhail Elfond |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1457572588 PECOS PAC ID: 9638277213 Enrollment ID: I20070605000394 |
| Provider Name | Nageh A Garas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821181249 PECOS PAC ID: 7618076316 Enrollment ID: I20070621000018 |
| Provider Name | Rameen Hashemiyoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346361730 PECOS PAC ID: 6002916459 Enrollment ID: I20070713000435 |
| Provider Name | Karen Sproul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700096773 PECOS PAC ID: 0941392351 Enrollment ID: I20070815000274 |
| Provider Name | Kenneth A Hirsch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972618296 PECOS PAC ID: 5597859140 Enrollment ID: I20070913000524 |
| Provider Name | Tommy Chau |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780876979 PECOS PAC ID: 6800977299 Enrollment ID: I20080110000670 |
| Provider Name | Patricia A Slokovitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962534263 PECOS PAC ID: 8628150901 Enrollment ID: I20080124000672 |
| Provider Name | Matthew S Projansky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083734008 PECOS PAC ID: 9335222603 Enrollment ID: I20080208000454 |
| Provider Name | Susan A Morin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285771188 PECOS PAC ID: 0941384648 Enrollment ID: I20080219000641 |
| Provider Name | Matthew I Goldman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689642886 PECOS PAC ID: 4385722644 Enrollment ID: I20080428000164 |
| Provider Name | Joseph M Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619174596 PECOS PAC ID: 5294808101 Enrollment ID: I20080724000588 |
| Provider Name | Melissa A Cusumano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568633147 PECOS PAC ID: 2062588270 Enrollment ID: I20080911000225 |
| Provider Name | Frank A Nyberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972625838 PECOS PAC ID: 1658433255 Enrollment ID: I20081216000267 |
| Provider Name | Ninfa M Mehta |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780889246 PECOS PAC ID: 5991852394 Enrollment ID: I20090421000478 |
| Provider Name | Syed K Hussaini |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437316148 PECOS PAC ID: 3375693062 Enrollment ID: I20090619000030 |
| Provider Name | Joseph Ng |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1699936104 PECOS PAC ID: 0941354104 Enrollment ID: I20090821000585 |
| Provider Name | Elham Safaie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932336492 PECOS PAC ID: 5395888242 Enrollment ID: I20100201000696 |
| Provider Name | Maritza L Groth |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306908314 PECOS PAC ID: 7810026325 Enrollment ID: I20100521000180 |
| Provider Name | Deidre F Sargent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114165628 PECOS PAC ID: 9830223767 Enrollment ID: I20100814000036 |
| Provider Name | Donna O Donoghue |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912948787 PECOS PAC ID: 8729112669 Enrollment ID: I20100814000201 |
| Provider Name | Eric S Cruzen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740265792 PECOS PAC ID: 6002860855 Enrollment ID: I20100825000697 |
| Provider Name | Nita K Malik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992937551 PECOS PAC ID: 3870775026 Enrollment ID: I20110309000014 |
| Provider Name | Andrus S Alian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306082326 PECOS PAC ID: 7113100751 Enrollment ID: I20110321000153 |
| Provider Name | Melissa S Devlin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1003078619 PECOS PAC ID: 1254514219 Enrollment ID: I20110329000381 |
| Provider Name | Pasqua T Spinelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366455537 PECOS PAC ID: 0244264653 Enrollment ID: I20110411000400 |
| Provider Name | Renata J Sterne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790095123 PECOS PAC ID: 6103000468 Enrollment ID: I20110411000611 |
| Provider Name | Phyllis F Macchio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699088955 PECOS PAC ID: 7911182357 Enrollment ID: I20110428000092 |
| Provider Name | Erica L Katz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215197728 PECOS PAC ID: 5496932352 Enrollment ID: I20110602000454 |
| Provider Name | Mityanand Ramnarine |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215173927 PECOS PAC ID: 9032397245 Enrollment ID: I20110616000685 |
| Provider Name | Javeria Nasim |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114189073 PECOS PAC ID: 6608044524 Enrollment ID: I20110720000721 |
| Provider Name | Lien H Lam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972820702 PECOS PAC ID: 2163696469 Enrollment ID: I20111123000356 |
| Provider Name | Jenna Taglienti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497915995 PECOS PAC ID: 7113180340 Enrollment ID: I20120525000016 |
| Provider Name | Stacy L Heuschneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063788578 PECOS PAC ID: 4385808252 Enrollment ID: I20120606000391 |
| Provider Name | Kenny Lien |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780858860 PECOS PAC ID: 7416103528 Enrollment ID: I20120806000476 |
| Provider Name | Nataliya Titarenko |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922242312 PECOS PAC ID: 8921258005 Enrollment ID: I20121025000738 |
| Provider Name | Christine A Arkali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962717512 PECOS PAC ID: 9537311345 Enrollment ID: I20121130000126 |
| Provider Name | Michael E Tofano |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770773814 PECOS PAC ID: 2668405168 Enrollment ID: I20121218000387 |
| Provider Name | John Paul R Blaber |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760625727 PECOS PAC ID: 6800049651 Enrollment ID: I20130104000163 |
| Provider Name | Marie Obrien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073860607 PECOS PAC ID: 5496995730 Enrollment ID: I20130709000551 |
| Provider Name | Binu Chacko |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265728398 PECOS PAC ID: 8224263355 Enrollment ID: I20131028000453 |
| Provider Name | Samar Sharma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891923900 PECOS PAC ID: 8729217823 Enrollment ID: I20140213001015 |
| Provider Name | Benjamin Kessler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164724548 PECOS PAC ID: 1052542024 Enrollment ID: I20140317000900 |
| Provider Name | Myat Myo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295995082 PECOS PAC ID: 7012084528 Enrollment ID: I20140319000745 |
| Provider Name | Ayse M Avcioglu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811126642 PECOS PAC ID: 8224292016 Enrollment ID: I20140409001318 |
| Provider Name | Yevhen Reznyk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720358575 PECOS PAC ID: 4385865260 Enrollment ID: I20141017000470 |
| Provider Name | Jennifer A Goebel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952699597 PECOS PAC ID: 0143442178 Enrollment ID: I20141106002483 |
| Provider Name | Liza Leung |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174787154 PECOS PAC ID: 0749442069 Enrollment ID: I20141210000126 |
| Provider Name | Patricia Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821495086 PECOS PAC ID: 3072830462 Enrollment ID: I20150324000755 |
| Provider Name | Attia K Hussain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205112729 PECOS PAC ID: 5597996504 Enrollment ID: I20150409001379 |
| Provider Name | Maureen T Cataldo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366836652 PECOS PAC ID: 1951612241 Enrollment ID: I20150612000041 |
| Provider Name | Omer Richman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154617165 PECOS PAC ID: 5799096467 Enrollment ID: I20150622001971 |
| Provider Name | Michael A Parrott |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235414178 PECOS PAC ID: 9830400449 Enrollment ID: I20150624000607 |
| Provider Name | Hammad Mohsin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205167624 PECOS PAC ID: 5092029629 Enrollment ID: I20150727002322 |
| Provider Name | Asma Iftikhar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1427344761 PECOS PAC ID: 2163664715 Enrollment ID: I20151221002446 |
| Provider Name | Dianne Layer-kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033501903 PECOS PAC ID: 1850697681 Enrollment ID: I20160304000243 |
| Provider Name | Francesco A Ferrari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952629917 PECOS PAC ID: 3173829736 Enrollment ID: I20160308000241 |
| Provider Name | Lisa Ambrose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902279029 PECOS PAC ID: 2668778663 Enrollment ID: I20160316001677 |
| Provider Name | Neal Hakimi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1508185471 PECOS PAC ID: 7315252087 Enrollment ID: I20160601001475 |
| Provider Name | Anas Sawas |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1184967135 PECOS PAC ID: 2668768052 Enrollment ID: I20160912000873 |
| Provider Name | Lauren M Sokolik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558620807 PECOS PAC ID: 4385931583 Enrollment ID: I20160930001378 |
| Provider Name | Jason Yan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053678250 PECOS PAC ID: 9739467770 Enrollment ID: I20161026002581 |
| Provider Name | Eddie J Kim |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1235428525 PECOS PAC ID: 3072731702 Enrollment ID: I20170126000143 |
| Provider Name | Pryanka Relan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851650931 PECOS PAC ID: 7416224753 Enrollment ID: I20170517001208 |
| Provider Name | Laura J Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245770734 PECOS PAC ID: 1557639994 Enrollment ID: I20170608000015 |
| Provider Name | Alain M Neri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063787760 PECOS PAC ID: 2365711942 Enrollment ID: I20170713002069 |
| Provider Name | Christopher J Polito |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447679147 PECOS PAC ID: 6305119934 Enrollment ID: I20170901002849 |
| Provider Name | Ozlem Bilgen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265791800 PECOS PAC ID: 9032420492 Enrollment ID: I20171002001651 |
| Provider Name | Dana L Soler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669916706 PECOS PAC ID: 8921374265 Enrollment ID: I20171101000007 |
| Provider Name | Catherine M Audus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346790755 PECOS PAC ID: 6608134275 Enrollment ID: I20180103002839 |
| Provider Name | Erin Mauricia Dainer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699090704 PECOS PAC ID: 1557664174 Enrollment ID: I20180116001066 |
| Provider Name | Maria S Rubino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760994248 PECOS PAC ID: 6800155912 Enrollment ID: I20180118001323 |
| Provider Name | Lora Lumubos Mamuyac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275053142 PECOS PAC ID: 2769744036 Enrollment ID: I20180326002534 |
| Provider Name | Susan Tansil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093949182 PECOS PAC ID: 6103060611 Enrollment ID: I20180514000200 |
| Provider Name | Philip Claire |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285991182 PECOS PAC ID: 8325303688 Enrollment ID: I20180607002236 |
| Provider Name | Richard Jason Lewis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558780189 PECOS PAC ID: 4284980863 Enrollment ID: I20180712001011 |
| Provider Name | Nader N Azab |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1922376367 PECOS PAC ID: 5890943880 Enrollment ID: I20180713000113 |
| Provider Name | Saad Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528400397 PECOS PAC ID: 5991094831 Enrollment ID: I20180904003505 |
| Provider Name | Ateaya A Lima |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912226069 PECOS PAC ID: 7618227869 Enrollment ID: I20180910000216 |
| Provider Name | Steven S Weiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215176094 PECOS PAC ID: 6103973722 Enrollment ID: I20180927000143 |
| Provider Name | Michael Ch Miller |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750769733 PECOS PAC ID: 7214289776 Enrollment ID: I20181010002978 |
| Provider Name | Amy J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851887517 PECOS PAC ID: 1456603687 Enrollment ID: I20181016002036 |
| Provider Name | Halyna Chykyda |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881073740 PECOS PAC ID: 1759633837 Enrollment ID: I20181018000818 |
| Provider Name | Christopher E Tsavaris |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073993192 PECOS PAC ID: 1355695800 Enrollment ID: I20181119003105 |
| Provider Name | Shaheer Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427435312 PECOS PAC ID: 2062756992 Enrollment ID: I20181204002693 |
| Provider Name | Melissa J Vecchio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831675511 PECOS PAC ID: 6002153616 Enrollment ID: I20190121000177 |
| Provider Name | Daniel M Shapiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407324478 PECOS PAC ID: 6204173818 Enrollment ID: I20190121000434 |
| Provider Name | Hilda L Enriquez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861822520 PECOS PAC ID: 1355684358 Enrollment ID: I20190514002967 |
| Provider Name | Elizabeth C Stachtiaris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679923536 PECOS PAC ID: 9638412950 Enrollment ID: I20190529002468 |
| Provider Name | Raymond Wong |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023462686 PECOS PAC ID: 2668710088 Enrollment ID: I20190830002310 |
| Provider Name | Bradley E Minter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578901542 PECOS PAC ID: 3476841446 Enrollment ID: I20190903000205 |
| Provider Name | Menatallah Algohary |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902260748 PECOS PAC ID: 2668717364 Enrollment ID: I20190903002300 |
| Provider Name | Yasser K Abdelbaki |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790149771 PECOS PAC ID: 0042549784 Enrollment ID: I20190905003090 |
| Provider Name | Syed W Hassan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265814446 PECOS PAC ID: 1759689946 Enrollment ID: I20190910001159 |
| Provider Name | Zachary Kuschner |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1578906178 PECOS PAC ID: 6103163225 Enrollment ID: I20190913001847 |
| Provider Name | Hong K Ng |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205299906 PECOS PAC ID: 0941547327 Enrollment ID: I20190924002336 |
| Provider Name | Eugene M Arena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356997308 PECOS PAC ID: 6204168925 Enrollment ID: I20191030002010 |
| Provider Name | Valarie R Lasala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134781552 PECOS PAC ID: 8426481706 Enrollment ID: I20191126002334 |
| Provider Name | Domenica Rappa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255677480 PECOS PAC ID: 4688008006 Enrollment ID: I20191218000648 |
| Provider Name | Toni L Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902455231 PECOS PAC ID: 4789011651 Enrollment ID: I20200305002174 |
| Provider Name | Wells J Brambl |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831552405 PECOS PAC ID: 9234483850 Enrollment ID: I20200422001990 |
| Provider Name | Cristina Bernadin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821514985 PECOS PAC ID: 8820429996 Enrollment ID: I20200506001347 |
| Provider Name | Michael O Aboagye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538448501 PECOS PAC ID: 4385075696 Enrollment ID: I20200520001365 |
| Provider Name | Jennifer R Rogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346752045 PECOS PAC ID: 8527489152 Enrollment ID: I20200605001322 |
| Provider Name | Jeffrey Kott |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1871024505 PECOS PAC ID: 4789009580 Enrollment ID: I20200713000700 |
| Provider Name | Michael J Lau |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497172548 PECOS PAC ID: 4486079076 Enrollment ID: I20200729003104 |
| Provider Name | Mubdiul I Ali |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1548528565 PECOS PAC ID: 3779893599 Enrollment ID: I20200915002326 |
| Provider Name | Glen T Granati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467872739 PECOS PAC ID: 4486993441 Enrollment ID: I20200917002215 |
| Provider Name | Andrea M Carr |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063876621 PECOS PAC ID: 7012261399 Enrollment ID: I20200921000708 |
| Provider Name | Katherine Quezada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952940942 PECOS PAC ID: 4789004979 Enrollment ID: I20201008001415 |
| Provider Name | Ali S Khan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225560469 PECOS PAC ID: 6709113806 Enrollment ID: I20201019000911 |
| Provider Name | Michael Nakhla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063943306 PECOS PAC ID: 5890049324 Enrollment ID: I20201030001924 |
| Provider Name | Melinda Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184999344 PECOS PAC ID: 7214347210 Enrollment ID: I20201103001135 |
| Provider Name | Karen K Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063542322 PECOS PAC ID: 3476964958 Enrollment ID: I20201205000190 |
| Provider Name | Thresiamma P Varughese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831501923 PECOS PAC ID: 4688088552 Enrollment ID: I20210204001421 |
| Provider Name | Debra D Giulietti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881205805 PECOS PAC ID: 1456766989 Enrollment ID: I20210216001474 |
| Provider Name | Trevor Bhullar Gill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275024291 PECOS PAC ID: 9739432006 Enrollment ID: I20210519000130 |
| Provider Name | Andrew Gregory Weber |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1922492305 PECOS PAC ID: 1951645753 Enrollment ID: I20210607002302 |
| Provider Name | Katie Marie Romeo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174029490 PECOS PAC ID: 4385045590 Enrollment ID: I20210625000581 |
| Provider Name | Iryna Matkovska |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265847891 PECOS PAC ID: 8729336078 Enrollment ID: I20210720001407 |
| Provider Name | Alexander Vincent Nello |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295231116 PECOS PAC ID: 7214330604 Enrollment ID: I20210722002110 |
| Provider Name | Salvatore Caiola |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801329438 PECOS PAC ID: 2860739406 Enrollment ID: I20210722002332 |
| Provider Name | Iryna Ilyasova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073005484 PECOS PAC ID: 1355678269 Enrollment ID: I20210812002017 |
| Provider Name | Darlene Mcday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932497195 PECOS PAC ID: 4385063916 Enrollment ID: I20210824002957 |
| Provider Name | Michael J Dayan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063898567 PECOS PAC ID: 3870998016 Enrollment ID: I20210825003469 |
| Provider Name | Christopher C Lee |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760879175 PECOS PAC ID: 9931450228 Enrollment ID: I20210826001799 |
| Provider Name | Juliana Chang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255837639 PECOS PAC ID: 8628475027 Enrollment ID: I20210928002654 |
| Provider Name | Lisa M Sammarco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518578780 PECOS PAC ID: 2264830835 Enrollment ID: I20211012002309 |
| Provider Name | Jesse L Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932696317 PECOS PAC ID: 3476893710 Enrollment ID: I20211117001288 |
| Provider Name | Wardah Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124508965 PECOS PAC ID: 3072857366 Enrollment ID: I20211122001671 |
| Provider Name | Varvara Boryushkina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164927661 PECOS PAC ID: 8426302795 Enrollment ID: I20211201002602 |
| Provider Name | Nicholas Seara |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518463389 PECOS PAC ID: 1759628100 Enrollment ID: I20220131000011 |
| Provider Name | Brian Christopher Ahearn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386140879 PECOS PAC ID: 9739581463 Enrollment ID: I20220510000587 |
| Provider Name | Cynthia E Cohen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235491762 PECOS PAC ID: 5092192096 Enrollment ID: I20220512001877 |
| Provider Name | Cameron Gittens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558037333 PECOS PAC ID: 6305223769 Enrollment ID: I20220524002802 |
| Provider Name | Jace M Reed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548798812 PECOS PAC ID: 3870868458 Enrollment ID: I20220601002680 |
| Provider Name | Heidi Schrader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972254290 PECOS PAC ID: 0143608059 Enrollment ID: I20220606001771 |
| Provider Name | Erin I Duffy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497215669 PECOS PAC ID: 4082010020 Enrollment ID: I20220622001645 |
| Provider Name | Swagato Bhattacharyya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720585458 PECOS PAC ID: 2062766538 Enrollment ID: I20220623001570 |
| Provider Name | Eric Chavis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760044887 PECOS PAC ID: 4183004286 Enrollment ID: I20220707001126 |
| Provider Name | Lan Chan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912353293 PECOS PAC ID: 4981970985 Enrollment ID: I20220714000444 |
| Provider Name | Angela Devine |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265992887 PECOS PAC ID: 0648507087 Enrollment ID: I20220810002063 |
| Provider Name | Stephanie Tsang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568922268 PECOS PAC ID: 6002147816 Enrollment ID: I20220818000732 |
| Provider Name | Devin M Howell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639639180 PECOS PAC ID: 4183951536 Enrollment ID: I20220818002943 |
| Provider Name | Christopher Tanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073001251 PECOS PAC ID: 2567846538 Enrollment ID: I20220825002233 |
| Provider Name | Joanna Stanczak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770089765 PECOS PAC ID: 6406100973 Enrollment ID: I20220826001459 |
| Provider Name | Jeena Elizabeth John |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093202871 PECOS PAC ID: 2365796844 Enrollment ID: I20220913001635 |
| Provider Name | Jamie Gilistro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699443408 PECOS PAC ID: 2466837802 Enrollment ID: I20220921000213 |
| Provider Name | Christopher Iamonaco |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760914683 PECOS PAC ID: 9537545090 Enrollment ID: I20221006001322 |
| Provider Name | Hyon J Bae |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215330717 PECOS PAC ID: 3971989393 Enrollment ID: I20221007000760 |
| Provider Name | Stephen J Paravati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396228425 PECOS PAC ID: 5496009714 Enrollment ID: I20221025001269 |
| Provider Name | Amna Ejaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952862872 PECOS PAC ID: 6305214826 Enrollment ID: I20221115000400 |
| Provider Name | Katherine Pandaliano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285354761 PECOS PAC ID: 0244609410 Enrollment ID: I20221209001093 |
| Provider Name | Jenna Nostramo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821726878 PECOS PAC ID: 7810368339 Enrollment ID: I20230120000688 |
| Provider Name | Edward T Perez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922627934 PECOS PAC ID: 4183099617 Enrollment ID: I20230413002344 |
| Provider Name | Shallu Sharma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265992119 PECOS PAC ID: 1052786530 Enrollment ID: I20230414001656 |
| Provider Name | Gospel Ofuyah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356069769 PECOS PAC ID: 4587020805 Enrollment ID: I20230511002175 |
| Provider Name | James R Pellegrini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619437845 PECOS PAC ID: 9830427202 Enrollment ID: I20230530002416 |
| Provider Name | Laura Vinci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073226650 PECOS PAC ID: 4486011830 Enrollment ID: I20230531001127 |
| Provider Name | Michael Ghiassi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255950440 PECOS PAC ID: 3173944279 Enrollment ID: I20230816002647 |
| Provider Name | Chet Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578247854 PECOS PAC ID: 0941654107 Enrollment ID: I20230922000110 |
| Provider Name | Sindhu Gollapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538782156 PECOS PAC ID: 7416302864 Enrollment ID: I20231005000459 |
| Provider Name | Henry E Mayo-malasky |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1346771243 PECOS PAC ID: 1355796939 Enrollment ID: I20231017003213 |
| Provider Name | Christine Mckeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053003558 PECOS PAC ID: 1254786833 Enrollment ID: I20231017003243 |
| Provider Name | Michael Mosca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952085433 PECOS PAC ID: 0446606966 Enrollment ID: I20231019001673 |
| Provider Name | George Lasker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265894265 PECOS PAC ID: 3476982661 Enrollment ID: I20231116001637 |
| Provider Name | Megan S Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861955338 PECOS PAC ID: 8628307626 Enrollment ID: I20231212002881 |
| Provider Name | Ralph Fabiani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104600865 PECOS PAC ID: 4082063243 Enrollment ID: I20231213001218 |
| Provider Name | Hamed Mian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740817345 PECOS PAC ID: 5496108227 Enrollment ID: I20240129002616 |
| Provider Name | Romana I Syed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184252108 PECOS PAC ID: 9830535327 Enrollment ID: I20240306003551 |
| Provider Name | Lisa Dubrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831347053 PECOS PAC ID: 9335379387 Enrollment ID: I20240307000081 |
| Provider Name | Rosemarie A Montecalvo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235692559 PECOS PAC ID: 7618313453 Enrollment ID: I20240314002627 |
| Provider Name | Waqas Shafique |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053930354 PECOS PAC ID: 3779947791 Enrollment ID: I20240404000375 |
| Provider Name | Morgan B O'shaughnessy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548940240 PECOS PAC ID: 2062852700 Enrollment ID: I20240429003043 |
| Provider Name | Audrey Spedding |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083242374 PECOS PAC ID: 8022459577 Enrollment ID: I20240515000469 |
| Provider Name | Jeannette Santulli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497946784 PECOS PAC ID: 2365859030 Enrollment ID: I20240523002666 |
| Provider Name | Krystal N Lomeli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235765298 PECOS PAC ID: 4284176348 Enrollment ID: I20240605001350 |
| Provider Name | Jaclyn Angielczyk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851977425 PECOS PAC ID: 6800338864 Enrollment ID: I20240605001485 |
| Provider Name | Giovanni C Santoro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699270272 PECOS PAC ID: 3173867421 Enrollment ID: I20240611003697 |
| Provider Name | Matthew Thomas Mills |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447836838 PECOS PAC ID: 8224571070 Enrollment ID: I20240620003340 |
| Provider Name | Nanette L Matos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912584384 PECOS PAC ID: 8729481171 Enrollment ID: I20240621002374 |
| Provider Name | Zain Javaid |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225664238 PECOS PAC ID: 7517326911 Enrollment ID: I20240624001312 |
| Provider Name | Joel Kleinberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710564406 PECOS PAC ID: 0446794465 Enrollment ID: I20240702000954 |
| Provider Name | Miriam Bello |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578145538 PECOS PAC ID: 0446794374 Enrollment ID: I20240702001369 |
| Provider Name | Shannon Elizabeth Sunny |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649850256 PECOS PAC ID: 6901340835 Enrollment ID: I20240702001703 |
| Provider Name | Richard Schwamb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750968079 PECOS PAC ID: 0547704397 Enrollment ID: I20240703001525 |
| Provider Name | Christopher Driscoll |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629697420 PECOS PAC ID: 9931643780 Enrollment ID: I20240703001818 |
| Provider Name | Philip Giarrusso |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144849563 PECOS PAC ID: 2769927268 Enrollment ID: I20240709002109 |
| Provider Name | Hassan Aftab Raza |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1477050482 PECOS PAC ID: 3173069200 Enrollment ID: I20240724003208 |
| Provider Name | Anna Yegiants |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073177762 PECOS PAC ID: 0345655338 Enrollment ID: I20240919001228 |
| Provider Name | Shehnaz Wasim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023695566 PECOS PAC ID: 4688115140 Enrollment ID: I20240924002773 |
| Provider Name | Mohamed Osman Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912534652 PECOS PAC ID: 7315470275 Enrollment ID: I20241030002734 |
| Provider Name | Demetrius D Mazidis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952979387 PECOS PAC ID: 0446783146 Enrollment ID: I20241104000715 |
| Provider Name | Henry G Yip |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295361202 PECOS PAC ID: 5890229199 Enrollment ID: I20241108002548 |
| Provider Name | Soha Salman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144781824 PECOS PAC ID: 7810223344 Enrollment ID: I20241115003136 |
| Provider Name | Isaac Pak |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1497249791 PECOS PAC ID: 2567997760 Enrollment ID: I20241125003288 |
Suffolk Brain And Nerve, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Route 112 Ste 300, Port Jefferson Station, NY 11776 Phone: 631-410-9420 Fax: 631-410-2017 | |
Turning Point Therapy, Lcsw, Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1050 Hallock Ave Ste 2, Port Jefferson Station, NY 11776 Phone: 631-793-9517 | |
Social Work For Counseling For Inspirational Living Lcsw Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6 Roosevelt Ave Ste 2, Port Jefferson Station, NY 11776 Phone: 631-474-1533 Fax: 631-474-1533 | |
Rise Therapy Lcsw Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1660 Route 112 Ste B, Port Jefferson Station, NY 11776 Phone: 631-253-8512 | |
Community Growth Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4515 Nesconset Hwy, Port Jefferson Station, NY 11776 Phone: 631-240-3471 | |
Ellen J Gordon Licensed Master Social Worker Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8 Roosevelt Ave, Port Jefferson Station, NY 11776 Phone: 631-736-7707 | |
Changing Seasons Counseling Lcsw Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 Old Town Rd, Port Jefferson Station, NY 11776 Phone: 631-209-7042 |