| Lmc Physician Services, Pc | |
|
150 55th St Brooklyn NY 11220-2559 | |
| (718) 630-8445 | |
| (718) 630-8515 |
| Full Name | Lmc Physician Services, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 150 55th St, Brooklyn, New York |
| Authorized Official Name and Position | Gary Dellacerra (VP MANAGED CARE & REVENUE COMPLIANC) |
| Authorized Official Contact | 7186307103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lmc Physician Services, Pc 5800 3rd Ave Lutheran Medical Center-managed Care Department Brooklyn NY 11220-3702 Ph: (718) 630-7477 | Lmc Physician Services, Pc 150 55th St Brooklyn NY 11220-2559 Ph: (718) 630-8445 |
| NPI Number | 1346256104 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 09/08/2008 |
| Medicare PECOS PAC ID | 5890686695 |
|---|---|
| Medicare Enrollment ID | O20040322001477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346256104 | NPI | - | NPPES |
| 01523151 | Medicaid | NY |
| Provider Name | Michael Argilla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336133743 PECOS PAC ID: 9537053434 Enrollment ID: I20040211000863 |
| Provider Name | Nachum Levin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508837840 PECOS PAC ID: 8820985617 Enrollment ID: I20040304000729 |
| Provider Name | Vladimir Privman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1659333193 PECOS PAC ID: 8426044587 Enrollment ID: I20040423000088 |
| Provider Name | Paul M Kelleher |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1326052473 PECOS PAC ID: 2567452550 Enrollment ID: I20040513000005 |
| Provider Name | Libia Moy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801967997 PECOS PAC ID: 6406846823 Enrollment ID: I20040517000613 |
| Provider Name | George S Ferzli |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497729081 PECOS PAC ID: 7517942543 Enrollment ID: I20040623000078 |
| Provider Name | Michael D Giasullo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1598702193 PECOS PAC ID: 2961487921 Enrollment ID: I20040623000331 |
| Provider Name | Steven W Salvati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578532073 PECOS PAC ID: 1951380534 Enrollment ID: I20040716000816 |
| Provider Name | Lauren A Shaiova |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1083696181 PECOS PAC ID: 3173591187 Enrollment ID: I20040917000798 |
| Provider Name | Rami Daya |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1154380376 PECOS PAC ID: 4587621503 Enrollment ID: I20041211000021 |
| Provider Name | David Myssiorek |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841361847 PECOS PAC ID: 7911955281 Enrollment ID: I20050104000713 |
| Provider Name | Peter J Pasqua |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760540058 PECOS PAC ID: 9436109212 Enrollment ID: I20050128000848 |
| Provider Name | Blanca R Vazquez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255449716 PECOS PAC ID: 6608828736 Enrollment ID: I20050216000624 |
| Provider Name | Alex A Latyshevsky |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1427154111 PECOS PAC ID: 6608823091 Enrollment ID: I20050407000535 |
| Provider Name | Gillian L Henry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376562017 PECOS PAC ID: 3870537715 Enrollment ID: I20050613000549 |
| Provider Name | Julia A Becker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003844861 PECOS PAC ID: 8628013356 Enrollment ID: I20050623000291 |
| Provider Name | Anne J Chun |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346237229 PECOS PAC ID: 0648208702 Enrollment ID: I20050729000737 |
| Provider Name | Melanie K Greifer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326164179 PECOS PAC ID: 9234164872 Enrollment ID: I20051003000091 |
| Provider Name | Avi Saperstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043434673 PECOS PAC ID: 8527088632 Enrollment ID: I20051205000537 |
| Provider Name | Robert Kaylakov |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1184683633 PECOS PAC ID: 9335160183 Enrollment ID: I20051208000671 |
| Provider Name | Alan M Langsner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619966702 PECOS PAC ID: 7810982816 Enrollment ID: I20060130000921 |
| Provider Name | Dmitri Kirpichnikov |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1982659660 PECOS PAC ID: 4981611522 Enrollment ID: I20060307000660 |
| Provider Name | Thao Ngo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770515108 PECOS PAC ID: 9739182221 Enrollment ID: I20060823000487 |
| Provider Name | Gregory R Brevetti |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1619954435 PECOS PAC ID: 4082612767 Enrollment ID: I20061111000039 |
| Provider Name | Corneliu T Vulpe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992815021 PECOS PAC ID: 8022016112 Enrollment ID: I20061128000432 |
| Provider Name | Jonathan Silver |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891704268 PECOS PAC ID: 0244239879 Enrollment ID: I20061208000557 |
| Provider Name | Raymond Walsh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003825456 PECOS PAC ID: 0840299236 Enrollment ID: I20061212000699 |
| Provider Name | Anthony Geraci |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871511238 PECOS PAC ID: 3779585799 Enrollment ID: I20070205000343 |
| Provider Name | Adib Alhaddad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124118831 PECOS PAC ID: 7416959085 Enrollment ID: I20070210000121 |
| Provider Name | Leonid Volfinzon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952403933 PECOS PAC ID: 8921102773 Enrollment ID: I20070403000601 |
| Provider Name | Dorcas C Morgan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144317652 PECOS PAC ID: 2062446545 Enrollment ID: I20070417000411 |
| Provider Name | George Fernaine |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184731119 PECOS PAC ID: 8224136841 Enrollment ID: I20070605000708 |
| Provider Name | Konstantin Zakashansky |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356557250 PECOS PAC ID: 8527168764 Enrollment ID: I20070717000377 |
| Provider Name | Olga V Filipova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164588554 PECOS PAC ID: 1456452887 Enrollment ID: I20070728000207 |
| Provider Name | Scott M Andes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891803037 PECOS PAC ID: 4486746526 Enrollment ID: I20070822000882 |
| Provider Name | Sonia A Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730250945 PECOS PAC ID: 3072607373 Enrollment ID: I20070918000137 |
| Provider Name | Thomas R Lyon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891800371 PECOS PAC ID: 5698863512 Enrollment ID: I20071110000007 |
| Provider Name | Sophia C Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811003379 PECOS PAC ID: 5294825311 Enrollment ID: I20071213000138 |
| Provider Name | Henri Robert Delbeau |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487725875 PECOS PAC ID: 5597845693 Enrollment ID: I20080102000186 |
| Provider Name | Jeremiah J Levine |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700957107 PECOS PAC ID: 4385724244 Enrollment ID: I20080104000055 |
| Provider Name | Suzannah D Berlyne |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1164599122 PECOS PAC ID: 1355422080 Enrollment ID: I20080118000327 |
| Provider Name | Nanwai Pak |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1396733531 PECOS PAC ID: 1456321173 Enrollment ID: I20080423000199 |
| Provider Name | Michael Bezuevsky |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1659541886 PECOS PAC ID: 8628157328 Enrollment ID: I20080507000031 |
| Provider Name | Danielle Geraldi-samara |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770764110 PECOS PAC ID: 6002985686 Enrollment ID: I20080522000166 |
| Provider Name | Mohsen Habib |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1053498865 PECOS PAC ID: 2264502079 Enrollment ID: I20080605000687 |
| Provider Name | Mario J Manna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295714020 PECOS PAC ID: 0143395897 Enrollment ID: I20080815000081 |
| Provider Name | Rajeev Balmiki |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1215945845 PECOS PAC ID: 5698842516 Enrollment ID: I20080918000472 |
| Provider Name | Calogero Gambino |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083889539 PECOS PAC ID: 4688742042 Enrollment ID: I20081013000202 |
| Provider Name | Nagi J Bustros |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316948680 PECOS PAC ID: 2365446622 Enrollment ID: I20081016000047 |
| Provider Name | Michael Timoney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790954196 PECOS PAC ID: 2365503422 Enrollment ID: I20081208000215 |
| Provider Name | Eric Dessner |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1861686545 PECOS PAC ID: 4486740693 Enrollment ID: I20081208000630 |
| Provider Name | Cynthia R Amirtharaj |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275791337 PECOS PAC ID: 1052472867 Enrollment ID: I20081211000117 |
| Provider Name | Joseph A Caruana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669451498 PECOS PAC ID: 3072677525 Enrollment ID: I20090127000618 |
| Provider Name | Galina Glinik |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679749477 PECOS PAC ID: 2163589268 Enrollment ID: I20090317000164 |
| Provider Name | Douglas R Lazzaro |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1568445096 PECOS PAC ID: 9234296559 Enrollment ID: I20090331000402 |
| Provider Name | Elena A Kuzin-palmeri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669471330 PECOS PAC ID: 7416036025 Enrollment ID: I20090409000377 |
| Provider Name | Mona Rigaud |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508851981 PECOS PAC ID: 4880741362 Enrollment ID: I20090421000282 |
| Provider Name | Feddy S Emmanuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053562900 PECOS PAC ID: 0840349098 Enrollment ID: I20090519000489 |
| Provider Name | Irina Kogan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679730477 PECOS PAC ID: 7810046984 Enrollment ID: I20090520000027 |
| Provider Name | Myint M Aye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326298688 PECOS PAC ID: 4981753928 Enrollment ID: I20090521000101 |
| Provider Name | Yevgeniya Pozharny |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407017189 PECOS PAC ID: 8820137375 Enrollment ID: I20091123000582 |
| Provider Name | Brian Flaherty |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083666846 PECOS PAC ID: 6406982057 Enrollment ID: I20100428000334 |
| Provider Name | Abha Kaistha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134104615 PECOS PAC ID: 8628106556 Enrollment ID: I20100513000207 |
| Provider Name | Akila Venkataraman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164417879 PECOS PAC ID: 9739219882 Enrollment ID: I20100616000228 |
| Provider Name | Archana Saxena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235301722 PECOS PAC ID: 2567537327 Enrollment ID: I20100706000310 |
| Provider Name | Yelena M Davydov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831204304 PECOS PAC ID: 6800929266 Enrollment ID: I20100805000368 |
| Provider Name | Nada G Abou Fayssal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225095292 PECOS PAC ID: 1153407713 Enrollment ID: I20100929001208 |
| Provider Name | Naira Ambarian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457568131 PECOS PAC ID: 7618163890 Enrollment ID: I20101130000928 |
| Provider Name | Susanna Lekhno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205070273 PECOS PAC ID: 3779770748 Enrollment ID: I20101203000517 |
| Provider Name | Nikolaos Ih Papamitsakis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467452797 PECOS PAC ID: 1658396387 Enrollment ID: I20101207000960 |
| Provider Name | Michael J Lacqua |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1992753883 PECOS PAC ID: 1759560543 Enrollment ID: I20110126000123 |
| Provider Name | Shailini Singh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831159177 PECOS PAC ID: 0648291435 Enrollment ID: I20110207000623 |
| Provider Name | Iraida Kazachkova |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619069457 PECOS PAC ID: 1759561558 Enrollment ID: I20110211000076 |
| Provider Name | Rabih A Nemr |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609026202 PECOS PAC ID: 7719169085 Enrollment ID: I20110308000235 |
| Provider Name | Melissa A Busovsky-mcneal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164748158 PECOS PAC ID: 6406038249 Enrollment ID: I20110315000693 |
| Provider Name | Thomas N Bustros |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1144409269 PECOS PAC ID: 2062699515 Enrollment ID: I20110609000172 |
| Provider Name | Daniela Rafii |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639322944 PECOS PAC ID: 5496933103 Enrollment ID: I20110629000505 |
| Provider Name | Robert Michael Greenberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912079070 PECOS PAC ID: 0446293765 Enrollment ID: I20110923000019 |
| Provider Name | Bruce F Garner |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1245337757 PECOS PAC ID: 4486827284 Enrollment ID: I20111021000480 |
| Provider Name | Achiau Ludomirsky |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770509994 PECOS PAC ID: 0143298653 Enrollment ID: I20111212000271 |
| Provider Name | Sharique Nazir |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457650665 PECOS PAC ID: 7517125735 Enrollment ID: I20120220000707 |
| Provider Name | Vijay J Mani |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194802397 PECOS PAC ID: 8022278423 Enrollment ID: I20120322000006 |
| Provider Name | Issam F Arnouk |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134223472 PECOS PAC ID: 7911167176 Enrollment ID: I20120326000307 |
| Provider Name | Deborah J Williams Denigris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699800631 PECOS PAC ID: 9830352376 Enrollment ID: I20120522000701 |
| Provider Name | Karthikeyan M Arcot |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205194941 PECOS PAC ID: 8921255647 Enrollment ID: I20120830000534 |
| Provider Name | Marwa M Moussa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972807600 PECOS PAC ID: 9537306451 Enrollment ID: I20130514000506 |
| Provider Name | Laura Malaga Dieguez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427215185 PECOS PAC ID: 0547409989 Enrollment ID: I20130617000221 |
| Provider Name | Linda W Law |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235390832 PECOS PAC ID: 1052486966 Enrollment ID: I20131017001503 |
| Provider Name | Doris Zavaro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083933311 PECOS PAC ID: 0547496432 Enrollment ID: I20131125000755 |
| Provider Name | Jose J Alberty Oller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205021672 PECOS PAC ID: 7214164698 Enrollment ID: I20131210000602 |
| Provider Name | Ihab I Ibrahim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083876809 PECOS PAC ID: 9638308240 Enrollment ID: I20140130001759 |
| Provider Name | Anne M Ocello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164773156 PECOS PAC ID: 8921239047 Enrollment ID: I20140402001373 |
| Provider Name | Luis R Saldana-gautier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891729695 PECOS PAC ID: 0941103485 Enrollment ID: I20140519001408 |
| Provider Name | Lili Zhu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093141194 PECOS PAC ID: 8325262926 Enrollment ID: I20140623001649 |
| Provider Name | Frida Fridman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932405768 PECOS PAC ID: 7315164084 Enrollment ID: I20140805000341 |
| Provider Name | Anju Malieckal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932409547 PECOS PAC ID: 4385861897 Enrollment ID: I20140806002518 |
| Provider Name | Zubin J Tharayil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306139589 PECOS PAC ID: 5698992667 Enrollment ID: I20140814002440 |
| Provider Name | Jennifer Yeung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780973057 PECOS PAC ID: 5092934943 Enrollment ID: I20140909000283 |
| Provider Name | Ramsey Joudeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174819353 PECOS PAC ID: 3274752639 Enrollment ID: I20140917000160 |
| Provider Name | Xiangna Tang |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790181030 PECOS PAC ID: 4789908674 Enrollment ID: I20150126000418 |
| Provider Name | Kaslyn Monah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689075715 PECOS PAC ID: 9537486543 Enrollment ID: I20150331001015 |
| Provider Name | Bina Shah |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1861528838 PECOS PAC ID: 3476871419 Enrollment ID: I20150423000424 |
| Provider Name | Mazen Iskandar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861783938 PECOS PAC ID: 2567775471 Enrollment ID: I20150722003381 |
| Provider Name | Bryan T Hopping |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205160090 PECOS PAC ID: 1254646391 Enrollment ID: I20150818005111 |
| Provider Name | Pieter Smit |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790923944 PECOS PAC ID: 5294971545 Enrollment ID: I20150929002730 |
St. Vincent's Services, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 66 Boerum Pl, Brooklyn, NY 11201 Phone: 718-422-2307 Fax: 718-422-2271 | |
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