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825 Chalkstone Ave Providence RI 02908-4728 | |
| (401) 456-2000 | |
| (401) 456-2029 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 825 Chalkstone Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Robert Jon Elders (SECRETARY) |
| Authorized Official Contact | 7147881249 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
825 Chalkstone Ave Providence RI 02908-4728 Ph: (401) 456-2000 | 825 Chalkstone Ave Providence RI 02908-4728 Ph: (401) 456-2000 |
| NPI Number | 1285059287 |
|---|---|
| Provider Enumeration Date | 02/27/2014 |
| Last Update Date | 01/11/2021 |
| Certification Date | 01/11/2021 |
| Medicare PECOS PAC ID | 0547492696 |
|---|---|
| Medicare Enrollment ID | O20140728001672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285059287 | NPI | - | NPPES |
| Provider Name | Ali A Akhtar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457333619 PECOS PAC ID: 0749193001 Enrollment ID: I20031112000055 |
| Provider Name | Gisele I Saliba |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629076351 PECOS PAC ID: 2567361017 Enrollment ID: I20040105000458 |
| Provider Name | Raymond F Chaquette |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1992706139 PECOS PAC ID: 8022008507 Enrollment ID: I20040517000246 |
| Provider Name | R James Koness |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1750348157 PECOS PAC ID: 1052302635 Enrollment ID: I20040521000684 |
| Provider Name | Michael L Stanchina |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518989367 PECOS PAC ID: 1557345188 Enrollment ID: I20040614000359 |
| Provider Name | Saira Hussain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891749016 PECOS PAC ID: 9133103534 Enrollment ID: I20040615000103 |
| Provider Name | Puneet Sud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598762346 PECOS PAC ID: 0749269249 Enrollment ID: I20040719000155 |
| Provider Name | Ghulam Mustafa Surti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861499675 PECOS PAC ID: 1456331354 Enrollment ID: I20040721001569 |
| Provider Name | Karen Mcdonald |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1841236718 PECOS PAC ID: 5890762470 Enrollment ID: I20040914000004 |
| Provider Name | William A Levin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669470886 PECOS PAC ID: 5597723007 Enrollment ID: I20041230000358 |
| Provider Name | Cynthia M Alves |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093712853 PECOS PAC ID: 4981652559 Enrollment ID: I20050111000024 |
| Provider Name | Ritesh Rathore |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1467459263 PECOS PAC ID: 8123077708 Enrollment ID: I20050120000963 |
| Provider Name | Gerald A Colvin |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1417954199 PECOS PAC ID: 3375592959 Enrollment ID: I20050120000977 |
| Provider Name | Michele S Nardi |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1891880878 PECOS PAC ID: 0749230324 Enrollment ID: I20050207000497 |
| Provider Name | Franklin D Mccool |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1063497576 PECOS PAC ID: 5496709495 Enrollment ID: I20050311000203 |
| Provider Name | John A Stoukides |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1639176357 PECOS PAC ID: 2961454053 Enrollment ID: I20050405000071 |
| Provider Name | Anila Peter-faherty |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861489775 PECOS PAC ID: 2567419203 Enrollment ID: I20050405000362 |
| Provider Name | John A Gaines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568457224 PECOS PAC ID: 2264479823 Enrollment ID: I20050414000762 |
| Provider Name | Amer B Malik |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679560684 PECOS PAC ID: 8527006378 Enrollment ID: I20050421000691 |
| Provider Name | Joseph Vincent Meharg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972556066 PECOS PAC ID: 1254379944 Enrollment ID: I20050422000414 |
| Provider Name | Sheila Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205852035 PECOS PAC ID: 7416998786 Enrollment ID: I20050517000556 |
| Provider Name | Gregory G Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043217250 PECOS PAC ID: 2668416637 Enrollment ID: I20050610000848 |
| Provider Name | Rajnish Bansal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417944190 PECOS PAC ID: 7416984612 Enrollment ID: I20050719001286 |
| Provider Name | Sajid Siddiq |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932107224 PECOS PAC ID: 4688605447 Enrollment ID: I20050822001304 |
| Provider Name | Thomas Lanna |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427055284 PECOS PAC ID: 6800820556 Enrollment ID: I20050921001064 |
| Provider Name | Deborah M Valletta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174650576 PECOS PAC ID: 7214962091 Enrollment ID: I20050929001067 |
| Provider Name | Kurush F Setna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932183571 PECOS PAC ID: 8729005822 Enrollment ID: I20051027001176 |
| Provider Name | Alex Etienne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447221866 PECOS PAC ID: 4385662436 Enrollment ID: I20051107000859 |
| Provider Name | Rebecca M Brown |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1437123403 PECOS PAC ID: 0648299149 Enrollment ID: I20051114001049 |
| Provider Name | Leah A Berg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992772438 PECOS PAC ID: 6507886116 Enrollment ID: I20051128000855 |
| Provider Name | David Kroessler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740211168 PECOS PAC ID: 7214838705 Enrollment ID: I20051209000439 |
| Provider Name | Maureen Harkavy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417911207 PECOS PAC ID: 9830104116 Enrollment ID: I20060207000900 |
| Provider Name | Laura G Rhue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538123336 PECOS PAC ID: 4082629274 Enrollment ID: I20060208000826 |
| Provider Name | Jeanne Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174588875 PECOS PAC ID: 2466463252 Enrollment ID: I20060508000749 |
| Provider Name | Nikola Dobrilovic |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1649228776 PECOS PAC ID: 7517979677 Enrollment ID: I20060608000273 |
| Provider Name | Neal Kelley |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033150701 PECOS PAC ID: 7113930033 Enrollment ID: I20060719000150 |
| Provider Name | Andrew Stone |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1538108857 PECOS PAC ID: 5698778223 Enrollment ID: I20060821000101 |
| Provider Name | Peter Pizzarello |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568420115 PECOS PAC ID: 9537163605 Enrollment ID: I20060831000518 |
| Provider Name | Bharti Rathore |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1821043795 PECOS PAC ID: 2062416795 Enrollment ID: I20060911000502 |
| Provider Name | Allison L Bernier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053429332 PECOS PAC ID: 4789680778 Enrollment ID: I20061016000115 |
| Provider Name | Nebyou Belay |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1194810507 PECOS PAC ID: 2860491032 Enrollment ID: I20061216000077 |
| Provider Name | Karen D Grande |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386708923 PECOS PAC ID: 9830191816 Enrollment ID: I20070203000154 |
| Provider Name | Heather K Glenn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952460636 PECOS PAC ID: 1355444852 Enrollment ID: I20070320000669 |
| Provider Name | Ponnandai S Somasundar |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1538212923 PECOS PAC ID: 3577667443 Enrollment ID: I20070402000702 |
| Provider Name | John P Miskovsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497743330 PECOS PAC ID: 9234235250 Enrollment ID: I20070507000671 |
| Provider Name | Dale L Folan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619162286 PECOS PAC ID: 5496843591 Enrollment ID: I20071126000354 |
| Provider Name | Nocif J Espat |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1225041361 PECOS PAC ID: 7911096763 Enrollment ID: I20071203000397 |
| Provider Name | Shiavax B Cowasji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679603617 PECOS PAC ID: 9739070012 Enrollment ID: I20080312000694 |
| Provider Name | Joseph Mazza |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912905209 PECOS PAC ID: 1850292277 Enrollment ID: I20081223000318 |
| Provider Name | Denis E Moonan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386626174 PECOS PAC ID: 2264597319 Enrollment ID: I20090224000586 |
| Provider Name | Steven Carl Katz |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1275793044 PECOS PAC ID: 2466503305 Enrollment ID: I20090706000376 |
| Provider Name | Khalid Alhourani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831232636 PECOS PAC ID: 8426101478 Enrollment ID: I20090808000108 |
| Provider Name | David M Donaldson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619196755 PECOS PAC ID: 0941354427 Enrollment ID: I20090818000585 |
| Provider Name | Richard A Regnante |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1023106614 PECOS PAC ID: 8123025434 Enrollment ID: I20090909000259 |
| Provider Name | Kristine M Mortel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396905832 PECOS PAC ID: 2062559883 Enrollment ID: I20091028000266 |
| Provider Name | Nakita R Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649402819 PECOS PAC ID: 6103965017 Enrollment ID: I20091207000527 |
| Provider Name | Scott E Mcdonald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942239363 PECOS PAC ID: 5193618130 Enrollment ID: I20100126000562 |
| Provider Name | Michael Peter Mariorenzi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093701948 PECOS PAC ID: 9436293685 Enrollment ID: I20100225000634 |
| Provider Name | Louis J Mariorenzi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194710814 PECOS PAC ID: 9436293693 Enrollment ID: I20100225000755 |
| Provider Name | Ira J Singer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275528903 PECOS PAC ID: 2860536034 Enrollment ID: I20100225000789 |
| Provider Name | Kenneth Rocco Catallozzi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417943291 PECOS PAC ID: 2264576438 Enrollment ID: I20100225000848 |
| Provider Name | William E Ottowitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932205655 PECOS PAC ID: 1456480334 Enrollment ID: I20100602000865 |
| Provider Name | Jordan S Dehaven |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750510988 PECOS PAC ID: 9739211400 Enrollment ID: I20100715000327 |
| Provider Name | Gregory J Austin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285620138 PECOS PAC ID: 3375676844 Enrollment ID: I20100804000506 |
| Provider Name | Walter E Donat |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144244534 PECOS PAC ID: 7315009305 Enrollment ID: I20100909000718 |
| Provider Name | William M Corrao |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033132816 PECOS PAC ID: 2567497332 Enrollment ID: I20101209000810 |
| Provider Name | Christopher M Brennan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174771323 PECOS PAC ID: 3476722802 Enrollment ID: I20110801000764 |
| Provider Name | Michael D Burgard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346458205 PECOS PAC ID: 7012181910 Enrollment ID: I20111110000361 |
| Provider Name | Richard William Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114122595 PECOS PAC ID: 9830364041 Enrollment ID: I20111215000669 |
| Provider Name | Michael A Battey |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1770662066 PECOS PAC ID: 8921073180 Enrollment ID: I20120220000858 |
| Provider Name | Michelle M Miceli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679821862 PECOS PAC ID: 8527218213 Enrollment ID: I20121015000162 |
| Provider Name | Jeanne M Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710121314 PECOS PAC ID: 5698925220 Enrollment ID: I20121017000356 |
| Provider Name | John K Findley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891777504 PECOS PAC ID: 8628052776 Enrollment ID: I20121018000516 |
| Provider Name | Kelly R Mooney |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801150685 PECOS PAC ID: 9032369251 Enrollment ID: I20121025000006 |
| Provider Name | Maria Aileen Soriano Pisaturo |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1598943250 PECOS PAC ID: 9739234287 Enrollment ID: I20130218000093 |
| Provider Name | Meredith A. Sherman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134450406 PECOS PAC ID: 4385889732 Enrollment ID: I20130408000022 |
| Provider Name | Todd F Roberts |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1003871336 PECOS PAC ID: 3173604758 Enrollment ID: I20130619000511 |
| Provider Name | Lidia Antonia Vognar |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1912148198 PECOS PAC ID: 9537309679 Enrollment ID: I20130712000326 |
| Provider Name | Nathalia Cristina Doobay |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1417253782 PECOS PAC ID: 4587805114 Enrollment ID: I20130724000806 |
| Provider Name | Aleksandra S Phillips |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316018450 PECOS PAC ID: 7012969439 Enrollment ID: I20130731000274 |
| Provider Name | Rabih El Bizri |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154524643 PECOS PAC ID: 8527150655 Enrollment ID: I20130802000524 |
| Provider Name | Phyllis Kelliher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598101925 PECOS PAC ID: 8527200518 Enrollment ID: I20130802000817 |
| Provider Name | Lauren De Leon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205154523 PECOS PAC ID: 6002050812 Enrollment ID: I20130918000112 |
| Provider Name | W. Vincent Perrelli |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1902806219 PECOS PAC ID: 3375598535 Enrollment ID: I20131121001254 |
| Provider Name | Dianne M Feeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013943323 PECOS PAC ID: 6103879036 Enrollment ID: I20131202001273 |
| Provider Name | Renata Sasson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538595525 PECOS PAC ID: 9830326362 Enrollment ID: I20131209000431 |
| Provider Name | Laura M Linback |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124294087 PECOS PAC ID: 9739311226 Enrollment ID: I20140416000536 |
| Provider Name | Jessica Lima Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699014423 PECOS PAC ID: 8325261837 Enrollment ID: I20140529002414 |
| Provider Name | Teresa Rose Garris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699194746 PECOS PAC ID: 5294952966 Enrollment ID: I20140805000446 |
| Provider Name | Kristina H Lavoie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487986881 PECOS PAC ID: 4789803636 Enrollment ID: I20140909000410 |
| Provider Name | Nidhi B Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407134745 PECOS PAC ID: 9638399983 Enrollment ID: I20141008001421 |
| Provider Name | Abdul Saied Calvino |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1770732497 PECOS PAC ID: 6406077361 Enrollment ID: I20141020000560 |
| Provider Name | Holli J Brousseau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225434558 PECOS PAC ID: 4183941024 Enrollment ID: I20150402000835 |
| Provider Name | Patrick Ofori-appiah |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508264920 PECOS PAC ID: 2567771710 Enrollment ID: I20151029000319 |
| Provider Name | Shera Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356786826 PECOS PAC ID: 9931403482 Enrollment ID: I20160204000165 |
| Provider Name | Quinn Flatley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689966764 PECOS PAC ID: 0547566432 Enrollment ID: I20160302001139 |
| Provider Name | Dana M Ferrazzano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699158733 PECOS PAC ID: 4688968761 Enrollment ID: I20160812000019 |
| Provider Name | Florian Koci |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780885285 PECOS PAC ID: 1355466095 Enrollment ID: I20160926000049 |
| Provider Name | Baldeep M Wirk |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1467412908 PECOS PAC ID: 3678665833 Enrollment ID: I20161123001056 |
| Provider Name | Kate B Noveau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255423430 PECOS PAC ID: 7810278421 Enrollment ID: I20161219002013 |
| Provider Name | Margaret Frempong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508176090 PECOS PAC ID: 8820371107 Enrollment ID: I20170210001881 |
| Provider Name | Kathryn E Mccullough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578014098 PECOS PAC ID: 9739308388 Enrollment ID: I20170223000152 |
| Provider Name | Alicia Rodio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215356076 PECOS PAC ID: 3870877434 Enrollment ID: I20170227000354 |
| Provider Name | Braidy Caitlin Shambaugh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972898773 PECOS PAC ID: 6608148861 Enrollment ID: I20170823000567 |
| Provider Name | Rosalie Ann Camacho |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508385568 PECOS PAC ID: 6608141015 Enrollment ID: I20171011002661 |
| Provider Name | Meredith E Sinel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487059895 PECOS PAC ID: 3072874817 Enrollment ID: I20180219002016 |
| Provider Name | Caitlin S Mcardle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508307240 PECOS PAC ID: 5092076794 Enrollment ID: I20180220002164 |
| Provider Name | Virginia Ruth Litle |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1598702284 PECOS PAC ID: 9830152891 Enrollment ID: I20180220002409 |
| Provider Name | Yuli Y Paula |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487038584 PECOS PAC ID: 2769743418 Enrollment ID: I20180221001192 |
| Provider Name | Emily J Dimon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326560004 PECOS PAC ID: 9830450337 Enrollment ID: I20180226000484 |
| Provider Name | Melissa Lamb |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1043686629 PECOS PAC ID: 7315228491 Enrollment ID: I20180227000781 |
| Provider Name | Kalpana R Polu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740219534 PECOS PAC ID: 9739172875 Enrollment ID: I20180301000455 |
| Provider Name | Heather Seger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427595602 PECOS PAC ID: 5294097416 Enrollment ID: I20180327002101 |
| Provider Name | R Bhawani Prasad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679534994 PECOS PAC ID: 2668510306 Enrollment ID: I20180406000713 |
| Provider Name | Brian Cohen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932546058 PECOS PAC ID: 4385861350 Enrollment ID: I20180516000164 |
| Provider Name | Travis Blood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700223815 PECOS PAC ID: 3577780014 Enrollment ID: I20180516001178 |
| Provider Name | Kendra Apici |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306368881 PECOS PAC ID: 7911252044 Enrollment ID: I20180613003070 |
| Provider Name | Simon F Desjardins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821387580 PECOS PAC ID: 5294035101 Enrollment ID: I20180614000162 |
| Provider Name | Rachel J Armada |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548754484 PECOS PAC ID: 4880938877 Enrollment ID: I20181203000330 |
| Provider Name | Jennifer L Deblois |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1093285751 PECOS PAC ID: 7214273838 Enrollment ID: I20190117003093 |
| Provider Name | Yun Li |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376868737 PECOS PAC ID: 9032456801 Enrollment ID: I20190201000315 |
| Provider Name | Patricia J Grendell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609006949 PECOS PAC ID: 2567709280 Enrollment ID: I20190202000180 |
| Provider Name | Ainsley K Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366913873 PECOS PAC ID: 5496093684 Enrollment ID: I20190213002394 |
| Provider Name | Tyler U Carden |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1427522051 PECOS PAC ID: 0345589107 Enrollment ID: I20190222001741 |
| Provider Name | Kim P Raposo Busa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457583247 PECOS PAC ID: 3577690197 Enrollment ID: I20190430002238 |
| Provider Name | Nicole Solk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013340421 PECOS PAC ID: 5597088971 Enrollment ID: I20190503001616 |
| Provider Name | Kapil Sankar Meleveedu |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1922353325 PECOS PAC ID: 8729381520 Enrollment ID: I20190722002849 |
| Provider Name | Robert William Macdonald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710532817 PECOS PAC ID: 7618206095 Enrollment ID: I20190910002782 |
| Provider Name | Monica L O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639459498 PECOS PAC ID: 9638467483 Enrollment ID: I20191021001885 |
| Provider Name | Melissa Vuolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497300909 PECOS PAC ID: 8921330606 Enrollment ID: I20191030000168 |
| Provider Name | Timur-metin Mujdaba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831570092 PECOS PAC ID: 3476885807 Enrollment ID: I20191104002399 |
| Provider Name | Leah Hurley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295381762 PECOS PAC ID: 7911339981 Enrollment ID: I20191112003331 |
| Provider Name | John Rodriguez |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1427210251 PECOS PAC ID: 4486849098 Enrollment ID: I20191209002062 |
| Provider Name | Cindy Marie Coite |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942491923 PECOS PAC ID: 5698102960 Enrollment ID: I20200226001098 |
| Provider Name | Michael Christopher Mariorenzi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861870321 PECOS PAC ID: 2163853516 Enrollment ID: I20200519001214 |
| Provider Name | Michael Leh Lin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477852713 PECOS PAC ID: 0446493498 Enrollment ID: I20201117002839 |
| Provider Name | Dalia Saha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033311204 PECOS PAC ID: 9830344043 Enrollment ID: I20201119000778 |
| Provider Name | Kimberly Jill Gallucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124627476 PECOS PAC ID: 8820400195 Enrollment ID: I20201210000025 |
| Provider Name | Thomas Defanti |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1043239783 PECOS PAC ID: 2668416512 Enrollment ID: I20210120002853 |
| Provider Name | Mahmood Hussain Sharfi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154311611 PECOS PAC ID: 6901823897 Enrollment ID: I20210122001072 |
| Provider Name | Jessica Belli Castronovo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740222421 PECOS PAC ID: 9931513363 Enrollment ID: I20210127000118 |
| Provider Name | Cindy Rojas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841833266 PECOS PAC ID: 0749694586 Enrollment ID: I20210205001759 |
| Provider Name | Anthony Joseph Paoletta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861090508 PECOS PAC ID: 1456767482 Enrollment ID: I20210317000044 |
| Provider Name | Linda Aguiar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457965998 PECOS PAC ID: 5890109243 Enrollment ID: I20210402000569 |
| Provider Name | Jessica L Collinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538752597 PECOS PAC ID: 2769890151 Enrollment ID: I20210423001917 |
| Provider Name | Jacquelyn Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942631858 PECOS PAC ID: 9032527320 Enrollment ID: I20210427001012 |
| Provider Name | Suraj Ram |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841451341 PECOS PAC ID: 5092122150 Enrollment ID: I20210528002279 |
| Provider Name | Lincoln Peter Tirpaeck |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245625045 PECOS PAC ID: 3173836830 Enrollment ID: I20210601001908 |
| Provider Name | Cristian Hiraldo-infante |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376039867 PECOS PAC ID: 1951645456 Enrollment ID: I20210803002482 |
| Provider Name | Elkins Guzman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679952451 PECOS PAC ID: 9830525575 Enrollment ID: I20210825000162 |
| Provider Name | Shahzad Mehr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508344474 PECOS PAC ID: 5395175665 Enrollment ID: I20210831002524 |
| Provider Name | Jenna L Butner |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1316258775 PECOS PAC ID: 3971724170 Enrollment ID: I20210917002656 |
| Provider Name | Margot Duchowny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174286116 PECOS PAC ID: 3870982937 Enrollment ID: I20211110001839 |
| Provider Name | Erica Beth Brousseau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508110479 PECOS PAC ID: 7012307531 Enrollment ID: I20211123003073 |
| Provider Name | Erika Lynn Leonard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285301507 PECOS PAC ID: 8224428453 Enrollment ID: I20211202001591 |
| Provider Name | Juan Gan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801001136 PECOS PAC ID: 7911226931 Enrollment ID: I20211214002553 |
| Provider Name | Emily Susan Rupert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912665001 PECOS PAC ID: 1951793439 Enrollment ID: I20220112002056 |
| Provider Name | Giovanna Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144977448 PECOS PAC ID: 7012304934 Enrollment ID: I20220425000442 |
| Provider Name | Griffin Reynolds |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1891181590 PECOS PAC ID: 6507263506 Enrollment ID: I20220608002674 |
| Provider Name | Paul Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174660732 PECOS PAC ID: 3678505864 Enrollment ID: I20220616001222 |
| Provider Name | Uchechukwu Ugorji |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033695986 PECOS PAC ID: 2567848583 Enrollment ID: I20220928003039 |
| Provider Name | Alice M Colon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093471054 PECOS PAC ID: 6507242294 Enrollment ID: I20221004001368 |
| Provider Name | Robinson Pierre-louis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649856022 PECOS PAC ID: 6103295431 Enrollment ID: I20221208002300 |
| Provider Name | Natalia M. Arboleda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639823057 PECOS PAC ID: 5698130888 Enrollment ID: I20230421001340 |
| Provider Name | Carmen Benjamin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063905180 PECOS PAC ID: 1759756406 Enrollment ID: I20230530001025 |
| Provider Name | Ralph Eugene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225435829 PECOS PAC ID: 8123495595 Enrollment ID: I20230607001402 |
| Provider Name | Joanna Sanzone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144731191 PECOS PAC ID: 3870841646 Enrollment ID: I20230626001381 |
| Provider Name | Sung Kwon |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1447458484 PECOS PAC ID: 5294013124 Enrollment ID: I20230626002057 |
| Provider Name | Melissa Muriel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265154850 PECOS PAC ID: 9335518620 Enrollment ID: I20230705002264 |
| Provider Name | Radowan Elnair |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1124479811 PECOS PAC ID: 6204123961 Enrollment ID: I20230724000751 |
| Provider Name | Estefania Clavijo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376150417 PECOS PAC ID: 6901269307 Enrollment ID: I20230901001494 |
| Provider Name | Jeremy Parker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780027888 PECOS PAC ID: 6507162906 Enrollment ID: I20230919000868 |
| Provider Name | Jason Lawrence Franklin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639941263 PECOS PAC ID: 4688023757 Enrollment ID: I20231214001910 |
| Provider Name | Kate Bowen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285872101 PECOS PAC ID: 6204289770 Enrollment ID: I20240131003419 |
| Provider Name | Valerie Jean Zuercher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023889391 PECOS PAC ID: 9638515109 Enrollment ID: I20240307001380 |
| Provider Name | Jennifer R. Losardo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689139248 PECOS PAC ID: 6305283821 Enrollment ID: I20240320000995 |
| Provider Name | Andrew Denicola |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104318138 PECOS PAC ID: 6305285073 Enrollment ID: I20240415000127 |
| Provider Name | Ruth Manu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669099503 PECOS PAC ID: 0941647820 Enrollment ID: I20240701004089 |
| Provider Name | Joanna Abi Chebl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700504396 PECOS PAC ID: 0648643072 Enrollment ID: I20240709000418 |
| Provider Name | Gregory Charpentier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073364147 PECOS PAC ID: 9739626920 Enrollment ID: I20240806001720 |
| Provider Name | Brynn Elizabeth Terry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215758347 PECOS PAC ID: 9931633500 Enrollment ID: I20241106000304 |
| Provider Name | Jacqueline Reams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558687475 PECOS PAC ID: 0244456184 Enrollment ID: I20241121000300 |
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