| Rih Pediatrics | |
|
593 Eddy St Providence RI 02903-4923 | |
| (401) 444-6195 | |
| (401) 444-6378 |
| Full Name | Rih Pediatrics |
|---|---|
| Speciality | Pediatrics |
| Location | 593 Eddy St, Providence, Rhode Island |
| Authorized Official Name and Position | Peter K Markell (EVP & CFO) |
| Authorized Official Contact | 4014447914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rih Pediatrics 117 Ellenfield St Suite 101 Providence RI 02905-4513 Ph: (401) 444-6905 | Rih Pediatrics 593 Eddy St Providence RI 02903-4923 Ph: (401) 444-6195 |
| NPI Number | 1861420333 |
|---|---|
| Provider Enumeration Date | 06/30/2006 |
| Last Update Date | 04/05/2023 |
| Certification Date | 04/05/2023 |
| Medicare PECOS PAC ID | 8921900044 |
|---|---|
| Medicare Enrollment ID | O20040121000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861420333 | NPI | - | NPPES |
| PP11293 | Medicaid | RI |
| Provider Name | Kathleen M Rotondo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972570422 PECOS PAC ID: 9638070758 Enrollment ID: I20040120000672 |
| Provider Name | Cynthia A Esteban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407895048 PECOS PAC ID: 0547162679 Enrollment ID: I20040121000249 |
| Provider Name | John N Gaitanis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225065394 PECOS PAC ID: 3375436215 Enrollment ID: I20040205000118 |
| Provider Name | Linda B Shalon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366497679 PECOS PAC ID: 4385530146 Enrollment ID: I20040226001204 |
| Provider Name | Nicholas M Grumbach |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932105780 PECOS PAC ID: 4183514193 Enrollment ID: I20040316000037 |
| Provider Name | Jennie J Muglia |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1538116686 PECOS PAC ID: 1951398478 Enrollment ID: I20040427001411 |
| Provider Name | Carolina S Cerezo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073596011 PECOS PAC ID: 3577545623 Enrollment ID: I20040603000219 |
| Provider Name | Sybil Cineas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053364984 PECOS PAC ID: 4587648720 Enrollment ID: I20040616000011 |
| Provider Name | Richard P Millman |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1699715813 PECOS PAC ID: 0143204289 Enrollment ID: I20040616000097 |
| Provider Name | William Douglas Brown |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588624647 PECOS PAC ID: 2860468345 Enrollment ID: I20040907000549 |
| Provider Name | Sara R Ford |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013989425 PECOS PAC ID: 8921077462 Enrollment ID: I20040930000705 |
| Provider Name | Carrie Kelly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568545630 PECOS PAC ID: 5991767105 Enrollment ID: I20041101000008 |
| Provider Name | Mohammed K Faizan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1255338240 PECOS PAC ID: 6608826003 Enrollment ID: I20050124000807 |
| Provider Name | Diane Dermarderosian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285688754 PECOS PAC ID: 3173574829 Enrollment ID: I20050210000041 |
| Provider Name | Christopher D Houck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821074576 PECOS PAC ID: 6709833361 Enrollment ID: I20050405001363 |
| Provider Name | Albert M Ross |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629016407 PECOS PAC ID: 2163448713 Enrollment ID: I20051021000857 |
| Provider Name | James W Ziegler |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346209459 PECOS PAC ID: 4385685437 Enrollment ID: I20051027000584 |
| Provider Name | Patricia J Flanagan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609820026 PECOS PAC ID: 7719905769 Enrollment ID: I20051108000501 |
| Provider Name | Amy Goldberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417994542 PECOS PAC ID: 7012935828 Enrollment ID: I20051109000896 |
| Provider Name | Chandan Lakhiani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235134495 PECOS PAC ID: 0648299610 Enrollment ID: I20051118000388 |
| Provider Name | Sherry Gagnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669446456 PECOS PAC ID: 5890715361 Enrollment ID: I20051129000516 |
| Provider Name | Carol Lewis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962456921 PECOS PAC ID: 1153341938 Enrollment ID: I20051130000451 |
| Provider Name | Natalia Golova |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609820208 PECOS PAC ID: 2567482870 Enrollment ID: I20051201000553 |
| Provider Name | Pamela High |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831143023 PECOS PAC ID: 4183638844 Enrollment ID: I20060201000714 |
| Provider Name | Ali Yalcindag |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750337796 PECOS PAC ID: 9032126933 Enrollment ID: I20060317000451 |
| Provider Name | Yvette E Yatchmink |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821044801 PECOS PAC ID: 1557378338 Enrollment ID: I20060320000605 |
| Provider Name | Patricia Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316986896 PECOS PAC ID: 7012925928 Enrollment ID: I20060403000709 |
| Provider Name | Linda Snelling |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134174592 PECOS PAC ID: 3476563982 Enrollment ID: I20060427000795 |
| Provider Name | Jerilyn Devin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477509081 PECOS PAC ID: 2961412135 Enrollment ID: I20060502000871 |
| Provider Name | Patricia Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093754624 PECOS PAC ID: 8022028208 Enrollment ID: I20060502000884 |
| Provider Name | Elizabeth Toll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619922085 PECOS PAC ID: 8820008824 Enrollment ID: I20060504000202 |
| Provider Name | Kristin Lehr Anderson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740236173 PECOS PAC ID: 2567474638 Enrollment ID: I20060608000321 |
| Provider Name | Delma Jean Watts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639194772 PECOS PAC ID: 9032113766 Enrollment ID: I20060911000527 |
| Provider Name | Gita Harappanahally |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093748378 PECOS PAC ID: 0042218141 Enrollment ID: I20061128000525 |
| Provider Name | Daphne Koinis- Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932143229 PECOS PAC ID: 4688674146 Enrollment ID: I20070105000441 |
| Provider Name | Emily R Katz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710058656 PECOS PAC ID: 4284634551 Enrollment ID: I20070110000493 |
| Provider Name | Kristin Soccio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578619532 PECOS PAC ID: 5193821734 Enrollment ID: I20070427000568 |
| Provider Name | Jose B Quintos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548248164 PECOS PAC ID: 5991766750 Enrollment ID: I20070613000445 |
| Provider Name | Kathleen R Donise |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134257348 PECOS PAC ID: 3971694779 Enrollment ID: I20070808000663 |
| Provider Name | Viren D Sa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326243866 PECOS PAC ID: 1951496173 Enrollment ID: I20071003000478 |
| Provider Name | John K Triedman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225009632 PECOS PAC ID: 1254372105 Enrollment ID: I20080103000746 |
| Provider Name | Lionel G Bercovitch |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1962473314 PECOS PAC ID: 2466435250 Enrollment ID: I20080625000231 |
| Provider Name | Jennifer Greene Welch |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1174741656 PECOS PAC ID: 9537233788 Enrollment ID: I20080806000028 |
| Provider Name | Elizabeth A Lowenhaupt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699972372 PECOS PAC ID: 6406923960 Enrollment ID: I20080925000004 |
| Provider Name | Kristin Lombardi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346467164 PECOS PAC ID: 9234299090 Enrollment ID: I20081124000466 |
| Provider Name | Suzanne E Mclaughlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215919782 PECOS PAC ID: 9335112515 Enrollment ID: I20081208000686 |
| Provider Name | Ivona Sediva |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073619391 PECOS PAC ID: 6800886565 Enrollment ID: I20081218000314 |
| Provider Name | Daniel Coghlin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942237847 PECOS PAC ID: 7315002078 Enrollment ID: I20090212000004 |
| Provider Name | Petra M Klinge |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1114169406 PECOS PAC ID: 5092863589 Enrollment ID: I20090512000197 |
| Provider Name | Barbara Kao |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972523975 PECOS PAC ID: 1456400662 Enrollment ID: I20090519000141 |
| Provider Name | Nicole R Nugent |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851527659 PECOS PAC ID: 3274689997 Enrollment ID: I20090922000632 |
| Provider Name | Jennifer Wolff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962643700 PECOS PAC ID: 9537215256 Enrollment ID: I20090922000641 |
| Provider Name | Julie Boergers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710961578 PECOS PAC ID: 7113055880 Enrollment ID: I20100518000018 |
| Provider Name | Michael P Koster |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1912031295 PECOS PAC ID: 8628109535 Enrollment ID: I20100621000709 |
| Provider Name | Richard M Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558345488 PECOS PAC ID: 6800929522 Enrollment ID: I20100802000904 |
| Provider Name | Michael F Blundin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982821484 PECOS PAC ID: 6103940804 Enrollment ID: I20100902000114 |
| Provider Name | Margaret M Mannix |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124276126 PECOS PAC ID: 9032302161 Enrollment ID: I20101021001074 |
| Provider Name | Brett Slingsby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811159031 PECOS PAC ID: 3678766300 Enrollment ID: I20101026000590 |
| Provider Name | Barbara N Jandasek |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972815249 PECOS PAC ID: 3779762935 Enrollment ID: I20110120000781 |
| Provider Name | Shuba Kamath |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295769941 PECOS PAC ID: 0749285369 Enrollment ID: I20110207000750 |
| Provider Name | Tanya Orie Rogo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417123886 PECOS PAC ID: 7416139316 Enrollment ID: I20110315000029 |
| Provider Name | Celeste Corcoran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639105810 PECOS PAC ID: 3971787060 Enrollment ID: I20110414000453 |
| Provider Name | Brett Goudie |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679627798 PECOS PAC ID: 4284736463 Enrollment ID: I20110617000205 |
| Provider Name | Jason Shapiro |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023235751 PECOS PAC ID: 4183894611 Enrollment ID: I20110819000043 |
| Provider Name | Matthew D Willis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912125345 PECOS PAC ID: 8729258264 Enrollment ID: I20110819000189 |
| Provider Name | Erica Chung |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700044468 PECOS PAC ID: 9739214982 Enrollment ID: I20110822000166 |
| Provider Name | Sarah Hagin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821378662 PECOS PAC ID: 8527226471 Enrollment ID: I20120222001090 |
| Provider Name | Kristen Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851668602 PECOS PAC ID: 9133388085 Enrollment ID: I20120312000877 |
| Provider Name | Alison J Riese |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255560694 PECOS PAC ID: 9133377450 Enrollment ID: I20120912000040 |
| Provider Name | Abigail Donaldson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427296300 PECOS PAC ID: 6002065612 Enrollment ID: I20120925000469 |
| Provider Name | Margaret Scheffler |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1639427479 PECOS PAC ID: 8527211564 Enrollment ID: I20121227000036 |
| Provider Name | Lauren Massingham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417000357 PECOS PAC ID: 8022253269 Enrollment ID: I20130318000343 |
| Provider Name | Chanika Phornphutkul |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639124530 PECOS PAC ID: 2668486754 Enrollment ID: I20130403000436 |
| Provider Name | Jeffrey Riese |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649408725 PECOS PAC ID: 5597904292 Enrollment ID: I20130610000221 |
| Provider Name | Lisa Swartz Topor |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215197355 PECOS PAC ID: 6901952092 Enrollment ID: I20130729000050 |
| Provider Name | Janet L Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619116993 PECOS PAC ID: 1355575663 Enrollment ID: I20130927000384 |
| Provider Name | Robin A Kremsdorf |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1902001431 PECOS PAC ID: 4587730932 Enrollment ID: I20131218000002 |
| Provider Name | Pei Chi Wu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063683407 PECOS PAC ID: 5890924112 Enrollment ID: I20140210000038 |
| Provider Name | Sharon Bonn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801047626 PECOS PAC ID: 4082845268 Enrollment ID: I20140401002209 |
| Provider Name | Allison Brindle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649206236 PECOS PAC ID: 2365413796 Enrollment ID: I20140408000396 |
| Provider Name | Michael Herzlinger |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275795726 PECOS PAC ID: 6901022904 Enrollment ID: I20140729000487 |
| Provider Name | Bradley Denardo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1508026261 PECOS PAC ID: 1052538741 Enrollment ID: I20140804000217 |
| Provider Name | Natalia Lukankina |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043466154 PECOS PAC ID: 8426277039 Enrollment ID: I20140915000195 |
| Provider Name | Stephanie L Rickerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790183069 PECOS PAC ID: 4183940372 Enrollment ID: I20150305001873 |
| Provider Name | Liza M. Aguiar |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861652349 PECOS PAC ID: 8224343348 Enrollment ID: I20150819007562 |
| Provider Name | Jennifer Jencks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063764652 PECOS PAC ID: 6002125424 Enrollment ID: I20151026000123 |
| Provider Name | Rebecca Macdonell Yilmaz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174883136 PECOS PAC ID: 7618194705 Enrollment ID: I20151027002669 |
| Provider Name | Lee Polikoff |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1720220007 PECOS PAC ID: 7416257142 Enrollment ID: I20151201002330 |
| Provider Name | Robin Mckinney |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1669752705 PECOS PAC ID: 8022318799 Enrollment ID: I20151202000512 |
| Provider Name | Kathleen B Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174965974 PECOS PAC ID: 9335442680 Enrollment ID: I20160121000305 |
| Provider Name | Vania L Kasper |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083994206 PECOS PAC ID: 3870710676 Enrollment ID: I20160125000580 |
| Provider Name | Albert Suk Won Woo |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1366460339 PECOS PAC ID: 4284679614 Enrollment ID: I20160502000468 |
| Provider Name | Debasree Banerjee |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1164742490 PECOS PAC ID: 7810115888 Enrollment ID: I20160720001606 |
| Provider Name | Sabina Danielle Holland |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1306075015 PECOS PAC ID: 7517102452 Enrollment ID: I20160815001235 |
| Provider Name | Silvia Chiang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356577001 PECOS PAC ID: 1759532153 Enrollment ID: I20161214001640 |
| Provider Name | Elizabeth S Dewitt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851527402 PECOS PAC ID: 0941591804 Enrollment ID: I20170317000198 |
| Provider Name | Sarah M Gay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225205206 PECOS PAC ID: 6103062583 Enrollment ID: I20170810000324 |
| Provider Name | Jack Rusley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639499395 PECOS PAC ID: 4981838760 Enrollment ID: I20170829000202 |
| Provider Name | Jason Richard Rafferty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104186089 PECOS PAC ID: 9234358813 Enrollment ID: I20170928004257 |
| Provider Name | Alyssa Beth Pullan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366983314 PECOS PAC ID: 7012282528 Enrollment ID: I20171010001721 |
| Provider Name | Konstantina A. Svokos |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1801108600 PECOS PAC ID: 5991061269 Enrollment ID: I20171102002993 |
| Provider Name | Sarah Spencer Welsh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063736874 PECOS PAC ID: 8325304074 Enrollment ID: I20171113001967 |
| Provider Name | Katherine E Mason |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801817234 PECOS PAC ID: 9638162720 Enrollment ID: I20171117002004 |
| Provider Name | Daniella Teape |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811222300 PECOS PAC ID: 4688955784 Enrollment ID: I20171120003597 |
| Provider Name | Monica Serrano Gonzalez |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1740589233 PECOS PAC ID: 6800154758 Enrollment ID: I20171222000116 |
| Provider Name | Ranna A Rozenfeld |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295741403 PECOS PAC ID: 8224222765 Enrollment ID: I20171228002649 |
| Provider Name | Tao Zheng |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1790712545 PECOS PAC ID: 2668422361 Enrollment ID: I20180209001791 |
| Provider Name | Linda Doberstein |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134665383 PECOS PAC ID: 0648525618 Enrollment ID: I20180614002007 |
| Provider Name | Roma Bhuta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396151668 PECOS PAC ID: 3971859760 Enrollment ID: I20180710000740 |
| Provider Name | Ana Cristina Albuja Ponce |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336581347 PECOS PAC ID: 7113231481 Enrollment ID: I20180712000236 |
| Provider Name | Patricia Poitevien |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245443845 PECOS PAC ID: 8123288255 Enrollment ID: I20180918000057 |
| Provider Name | Rishi Ramesh Lulla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801811591 PECOS PAC ID: 6103828124 Enrollment ID: I20180920002463 |
| Provider Name | Julia Schulkers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841778297 PECOS PAC ID: 6002168077 Enrollment ID: I20181003001197 |
| Provider Name | Rachit Patil |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740574425 PECOS PAC ID: 1850610049 Enrollment ID: I20181005001943 |
| Provider Name | Marc Jonathan Perkel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932337748 PECOS PAC ID: 2769735802 Enrollment ID: I20181019000353 |
| Provider Name | Shova Subedi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801102470 PECOS PAC ID: 1052539616 Enrollment ID: I20181019001411 |
| Provider Name | Marcella Rita Aquino |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1356563670 PECOS PAC ID: 4183785108 Enrollment ID: I20181203003112 |
| Provider Name | Donald Marc Laliberte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174974547 PECOS PAC ID: 5698016350 Enrollment ID: I20190405000319 |
| Provider Name | Salley Pels |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1114100104 PECOS PAC ID: 8426182866 Enrollment ID: I20190514000490 |
| Provider Name | Amanda Flora Bellamy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205395662 PECOS PAC ID: 7214270990 Enrollment ID: I20190521001278 |
| Provider Name | William Lewis-de Los Angeles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073930053 PECOS PAC ID: 5496031437 Enrollment ID: I20190618002470 |
| Provider Name | Meghan E Fredette |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1912249335 PECOS PAC ID: 1759676091 Enrollment ID: I20190619000069 |
| Provider Name | Emily B Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457610198 PECOS PAC ID: 0749413706 Enrollment ID: I20190620002901 |
| Provider Name | Matthew L Lorenz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740661016 PECOS PAC ID: 6002123098 Enrollment ID: I20190702000245 |
| Provider Name | Justin Berk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245625300 PECOS PAC ID: 3678891827 Enrollment ID: I20190716001894 |
| Provider Name | Sibel Alev Algon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891851648 PECOS PAC ID: 8224290143 Enrollment ID: I20190806002524 |
| Provider Name | Nivedita Muralidhar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568819407 PECOS PAC ID: 9335434786 Enrollment ID: I20191018000301 |
| Provider Name | Dana L Egan-sherry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780032557 PECOS PAC ID: 8022303130 Enrollment ID: I20191023001639 |
| Provider Name | Angela Dziok |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861953564 PECOS PAC ID: 0446682017 Enrollment ID: I20191120000843 |
| Provider Name | Jessica Holt Olingy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093096513 PECOS PAC ID: 4082047204 Enrollment ID: I20191202002159 |
| Provider Name | Hsi-yang Wu |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578539870 PECOS PAC ID: 9335247105 Enrollment ID: I20191213001343 |
| Provider Name | Christine M Nunes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245528421 PECOS PAC ID: 8224397286 Enrollment ID: I20191218001486 |
| Provider Name | Elizabeth Mintzes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568878627 PECOS PAC ID: 8820317704 Enrollment ID: I20200205001431 |
| Provider Name | Von Marie Rodriguez-guzman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831505163 PECOS PAC ID: 2668895707 Enrollment ID: I20200708003098 |
| Provider Name | Melissa Lynn Verdolotti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588289268 PECOS PAC ID: 4587080692 Enrollment ID: I20200820000499 |
| Provider Name | Duyu Nie |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528473527 PECOS PAC ID: 3577980341 Enrollment ID: I20200826000436 |
| Provider Name | William Brucker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942543962 PECOS PAC ID: 3072816511 Enrollment ID: I20200916000865 |
| Provider Name | Manpreet Kochhar |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1952788994 PECOS PAC ID: 6204256076 Enrollment ID: I20201015003049 |
| Provider Name | Jessica Mccurry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063869287 PECOS PAC ID: 0143640417 Enrollment ID: I20201027000104 |
| Provider Name | Olutosin A Ojugbele |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154741643 PECOS PAC ID: 1153682588 Enrollment ID: I20201109001448 |
| Provider Name | Lindo Spencer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306877147 PECOS PAC ID: 9335239151 Enrollment ID: I20201111002007 |
| Provider Name | Rachel Weitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982210977 PECOS PAC ID: 3971913369 Enrollment ID: I20201114000067 |
| Provider Name | Jo Ann R Stengel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285796037 PECOS PAC ID: 1254743826 Enrollment ID: I20201224000540 |
| Provider Name | Paula Jean Mcevoy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053356329 PECOS PAC ID: 3274945852 Enrollment ID: I20201228000108 |
| Provider Name | Michelle Lopes Alves |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1598188732 PECOS PAC ID: 4284034687 Enrollment ID: I20210607000935 |
| Provider Name | Mitch C Otu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154785061 PECOS PAC ID: 3577897008 Enrollment ID: I20210723002110 |
| Provider Name | Patrick Thomas Mcgann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912034364 PECOS PAC ID: 2769600964 Enrollment ID: I20210813001421 |
| Provider Name | Melinda Dewald Delaney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649703497 PECOS PAC ID: 1254600877 Enrollment ID: I20210819003824 |
| Provider Name | Jennifer A Cueto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386092765 PECOS PAC ID: 4082019435 Enrollment ID: I20210823002045 |
| Provider Name | Vincent Dimaggio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083053896 PECOS PAC ID: 7315240470 Enrollment ID: I20211026001060 |
| Provider Name | Christina Marie D'angelo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962074476 PECOS PAC ID: 3274921002 Enrollment ID: I20211028001344 |
| Provider Name | Lauren Rose Schiappa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144837790 PECOS PAC ID: 6103215892 Enrollment ID: I20211118001862 |
| Provider Name | Savannah Lynn Babcock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730845199 PECOS PAC ID: 2466843495 Enrollment ID: I20211229001136 |
| Provider Name | Maryalice Brislin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558852210 PECOS PAC ID: 5496003295 Enrollment ID: I20220404002257 |
| Provider Name | Sandra Jimenez Giraldo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871974360 PECOS PAC ID: 1557757846 Enrollment ID: I20220414000516 |
| Provider Name | Ann Ding |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376034363 PECOS PAC ID: 9032464367 Enrollment ID: I20220512000022 |
| Provider Name | Jonathan Nyce |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093177008 PECOS PAC ID: 4880930247 Enrollment ID: I20220610000053 |
| Provider Name | Kate Millington |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306263843 PECOS PAC ID: 1052676624 Enrollment ID: I20220615001096 |
| Provider Name | Kevin Scully |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770978363 PECOS PAC ID: 8123332640 Enrollment ID: I20220615002731 |
| Provider Name | Daniel Horim Choi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306239298 PECOS PAC ID: 0840565081 Enrollment ID: I20220629000359 |
| Provider Name | Mehtap Haktanir Abul |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265979421 PECOS PAC ID: 4688005994 Enrollment ID: I20220720002649 |
| Provider Name | Hannah L Fassel Justus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255696951 PECOS PAC ID: 2668788159 Enrollment ID: I20220804001339 |
| Provider Name | Tessa Jude Centracchio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982296992 PECOS PAC ID: 3678955549 Enrollment ID: I20220809002781 |
| Provider Name | Tanya Murtha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265879266 PECOS PAC ID: 9830454024 Enrollment ID: I20220906001409 |
| Provider Name | Monica Ruiz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982059689 PECOS PAC ID: 8729378245 Enrollment ID: I20220920000575 |
| Provider Name | Pamela Alida Scalise |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407216369 PECOS PAC ID: 2860877016 Enrollment ID: I20220923002177 |
| Provider Name | Melissa Pielech |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881076586 PECOS PAC ID: 0547646390 Enrollment ID: I20220930001476 |
| Provider Name | Edward Gill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861805681 PECOS PAC ID: 5890084180 Enrollment ID: I20221118002093 |
| Provider Name | Irina Gorbounova |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235588245 PECOS PAC ID: 5597003145 Enrollment ID: I20221118002395 |
| Provider Name | Kelsey Paige Hart |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609372705 PECOS PAC ID: 9032587241 Enrollment ID: I20221118002416 |
| Provider Name | Anthony Carl Rodrigues |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740613371 PECOS PAC ID: 0345469326 Enrollment ID: I20221129000818 |
| Provider Name | Hareem Park |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770920431 PECOS PAC ID: 1658653399 Enrollment ID: I20221201000306 |
| Provider Name | Michelle Pievsky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548884638 PECOS PAC ID: 3072932524 Enrollment ID: I20221206001195 |
| Provider Name | Tomo Tarui |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578732053 PECOS PAC ID: 3274701339 Enrollment ID: I20221220000184 |
| Provider Name | Tess Marie Cagenello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407591894 PECOS PAC ID: 6608246327 Enrollment ID: I20221221001148 |
| Provider Name | Caroline James Kistin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417114059 PECOS PAC ID: 7416023916 Enrollment ID: I20221228001755 |
| Provider Name | Marissa Getman Finger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710603923 PECOS PAC ID: 1355712191 Enrollment ID: I20230113001956 |
| Provider Name | Lynne Brownell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679615140 PECOS PAC ID: 9931256336 Enrollment ID: I20230212000007 |
| Provider Name | Abigail Keogh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043673312 PECOS PAC ID: 5698156628 Enrollment ID: I20230224001436 |
| Provider Name | Ashley Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780068866 PECOS PAC ID: 0648681767 Enrollment ID: I20230228001796 |
| Provider Name | Maayan Leroy-melamed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942627997 PECOS PAC ID: 3971721879 Enrollment ID: I20230302001647 |
| Provider Name | Alison Manning |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376980425 PECOS PAC ID: 6305066002 Enrollment ID: I20230306001506 |
| Provider Name | Molly Taylor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790135879 PECOS PAC ID: 9032448824 Enrollment ID: I20230405001473 |
| Provider Name | Brian Lurie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528138740 PECOS PAC ID: 7416030515 Enrollment ID: I20230425000593 |
| Provider Name | Valerie Kiers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538712997 PECOS PAC ID: 8224465984 Enrollment ID: I20230511000219 |
| Provider Name | Americo Eloy Esquibies |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316920523 PECOS PAC ID: 5799755880 Enrollment ID: I20230524002668 |
| Provider Name | Tania M Rodriguez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558984690 PECOS PAC ID: 8628499746 Enrollment ID: I20230621002272 |
| Provider Name | Prerana Baranwal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013302058 PECOS PAC ID: 8820335946 Enrollment ID: I20230621002619 |
| Provider Name | Danielle Sophia Cirillo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427686617 PECOS PAC ID: 7416378559 Enrollment ID: I20230627001733 |
| Provider Name | Thomas J Seery |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639198096 PECOS PAC ID: 3274719257 Enrollment ID: I20230707001056 |
| Provider Name | Vicenta Hudziak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598257842 PECOS PAC ID: 4385999820 Enrollment ID: I20230725002254 |
| Provider Name | Jessica Torabi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992215883 PECOS PAC ID: 7214295310 Enrollment ID: I20230801001967 |
| Provider Name | Amy Jeanne Rasmussen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053848234 PECOS PAC ID: 9032488689 Enrollment ID: I20230802002268 |
| Provider Name | Jessica Brooke Hanratty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932881133 PECOS PAC ID: 5698139657 Enrollment ID: I20230911001630 |
| Provider Name | Jennifer Fishbein |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730611260 PECOS PAC ID: 8325401185 Enrollment ID: I20231002002853 |
| Provider Name | Vivien Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902566177 PECOS PAC ID: 3870989718 Enrollment ID: I20231207001647 |
| Provider Name | Anne K Underhill |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1861192445 PECOS PAC ID: 3870943863 Enrollment ID: I20240103003020 |
| Provider Name | Shannon M. Pine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427671478 PECOS PAC ID: 7113378308 Enrollment ID: I20240112000186 |
| Provider Name | Timothy Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952924813 PECOS PAC ID: 8224480397 Enrollment ID: I20240115001130 |
| Provider Name | Paulo Renato Pina |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609974740 PECOS PAC ID: 2264496702 Enrollment ID: I20240130002319 |
| Provider Name | Krisha Corbo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790163970 PECOS PAC ID: 1951745355 Enrollment ID: I20240213004047 |
| Provider Name | Laura Lynn Moynihan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154989853 PECOS PAC ID: 6709226160 Enrollment ID: I20240502000161 |
| Provider Name | Gregory Lopez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821663824 PECOS PAC ID: 7012316029 Enrollment ID: I20240514002317 |
| Provider Name | Grace Cushman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881459931 PECOS PAC ID: 1355883984 Enrollment ID: I20240611000153 |
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