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680 Centre St Brockton MA 02302-3308 | |
| (508) 941-7000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 680 Centre St, Brockton, Massachusetts |
| Authorized Official Name and Position | Cynthia Marie Colby (DIRECTOR, MANAGED CARE) |
| Authorized Official Contact | 5089410958 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
680 Centre St Brockton MA 02302-3308 Ph: (508) 894-0400 | 680 Centre St Brockton MA 02302-3308 Ph: (508) 941-7000 |
| NPI Number | 1508804949 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/27/2023 |
| Medicare PECOS PAC ID | 7719876267 |
|---|---|
| Medicare Enrollment ID | O20040312000372 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508804949 | NPI | - | NPPES |
| 110072349A | Medicaid | MA | |
| M16402 | Other | MA | BCBS GROUP # |
| Provider Name | Dino Constantinou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770578932 PECOS PAC ID: 2769384296 Enrollment ID: I20040123000901 |
| Provider Name | Babington C Yung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881647394 PECOS PAC ID: 4082503370 Enrollment ID: I20040315000013 |
| Provider Name | Sridhar H Dasari |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912991068 PECOS PAC ID: 9234020819 Enrollment ID: I20040323000870 |
| Provider Name | Aida Mallouhi Hanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063440220 PECOS PAC ID: 0446142186 Enrollment ID: I20040326000958 |
| Provider Name | Daniel Muse |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396729786 PECOS PAC ID: 6608869474 Enrollment ID: I20040407000100 |
| Provider Name | Warren Salzman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316993587 PECOS PAC ID: 9830182658 Enrollment ID: I20040407000466 |
| Provider Name | Christine Petruzzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831174440 PECOS PAC ID: 7810981099 Enrollment ID: I20040412000535 |
| Provider Name | Heather Tarrant |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396771390 PECOS PAC ID: 5991799827 Enrollment ID: I20040413000694 |
| Provider Name | Rolf Freter |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1457338576 PECOS PAC ID: 2567456114 Enrollment ID: I20040414001289 |
| Provider Name | Ahmed Atia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508827593 PECOS PAC ID: 9638165640 Enrollment ID: I20040423001240 |
| Provider Name | Therese Redmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568479954 PECOS PAC ID: 2668453176 Enrollment ID: I20040528000825 |
| Provider Name | Tiegang Ding |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508827429 PECOS PAC ID: 3476536889 Enrollment ID: I20040608000724 |
| Provider Name | Martha P Slattery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619127040 PECOS PAC ID: 9739162793 Enrollment ID: I20040610000743 |
| Provider Name | Andrew Koslow |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083651723 PECOS PAC ID: 5991788580 Enrollment ID: I20040614000042 |
| Provider Name | Anne Ruggieri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699707901 PECOS PAC ID: 5698759157 Enrollment ID: I20040614001384 |
| Provider Name | Yung Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265488126 PECOS PAC ID: 8527038066 Enrollment ID: I20040730000455 |
| Provider Name | Huan T Ngo |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1619913175 PECOS PAC ID: 3779554126 Enrollment ID: I20040802000388 |
| Provider Name | Jane Y Yu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902887888 PECOS PAC ID: 7113999897 Enrollment ID: I20040812000257 |
| Provider Name | Richard D Mulroy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700829652 PECOS PAC ID: 2961475777 Enrollment ID: I20040818000996 |
| Provider Name | James T Roan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275602393 PECOS PAC ID: 2466414396 Enrollment ID: I20041102000731 |
| Provider Name | Bruce Bertrand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215918891 PECOS PAC ID: 1355307315 Enrollment ID: I20041202000188 |
| Provider Name | Christian Campos |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1235238882 PECOS PAC ID: 0446218697 Enrollment ID: I20041221000065 |
| Provider Name | Karen L Giles |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720007974 PECOS PAC ID: 5991691206 Enrollment ID: I20041229000613 |
| Provider Name | Humayon B. Khan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1629016944 PECOS PAC ID: 9739130451 Enrollment ID: I20050209000899 |
| Provider Name | Andrew R Weintraub |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699850867 PECOS PAC ID: 7113971706 Enrollment ID: I20050307000499 |
| Provider Name | Jeffrey I Gassman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093736910 PECOS PAC ID: 1254386790 Enrollment ID: I20050317000048 |
| Provider Name | Michael L Dern |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710968136 PECOS PAC ID: 2163402454 Enrollment ID: I20050324000743 |
| Provider Name | Padmaja Parayath |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174515183 PECOS PAC ID: 3779547203 Enrollment ID: I20050328000962 |
| Provider Name | Robert E Weinstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881645679 PECOS PAC ID: 8729034236 Enrollment ID: I20050329000071 |
| Provider Name | Allan D Lauer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1427001767 PECOS PAC ID: 8820045677 Enrollment ID: I20050404000661 |
| Provider Name | Richard C Fiorini |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649260514 PECOS PAC ID: 1658328380 Enrollment ID: I20050405001051 |
| Provider Name | Eric J Sax |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750364717 PECOS PAC ID: 6709823032 Enrollment ID: I20050408000457 |
| Provider Name | Thomas A Morris |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083724553 PECOS PAC ID: 9436196425 Enrollment ID: I20050412000187 |
| Provider Name | Lauren R Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730163262 PECOS PAC ID: 4486693884 Enrollment ID: I20050426000572 |
| Provider Name | Nicolaos Athienites |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1902804107 PECOS PAC ID: 5395784375 Enrollment ID: I20050428000839 |
| Provider Name | Arthur L Zerbey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164417978 PECOS PAC ID: 9537100482 Enrollment ID: I20050520000320 |
| Provider Name | May C Louie |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740265354 PECOS PAC ID: 2365484359 Enrollment ID: I20050601000096 |
| Provider Name | Charles I Haffajee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952397523 PECOS PAC ID: 9739124777 Enrollment ID: I20050621000827 |
| Provider Name | Shreekant Chopra |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1740288943 PECOS PAC ID: 0042255382 Enrollment ID: I20050627000923 |
| Provider Name | Geoffrey G Binney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811931991 PECOS PAC ID: 2062449424 Enrollment ID: I20050719000015 |
| Provider Name | Vanessa R Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558455139 PECOS PAC ID: 8921036906 Enrollment ID: I20050801000372 |
| Provider Name | Michael J Mccoobery |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659352516 PECOS PAC ID: 8921039215 Enrollment ID: I20050826000088 |
| Provider Name | Kevin P Petit |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750400461 PECOS PAC ID: 0840217345 Enrollment ID: I20051024001018 |
| Provider Name | Phillip D Mccrary |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861488967 PECOS PAC ID: 6103860952 Enrollment ID: I20051029000161 |
| Provider Name | Timothy E Frey |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1053467969 PECOS PAC ID: 5395763643 Enrollment ID: I20051105000146 |
| Provider Name | Dianne Healy Quadros |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1376528992 PECOS PAC ID: 1658391008 Enrollment ID: I20051130000180 |
| Provider Name | Schahid A Rawoof |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649270182 PECOS PAC ID: 4587638606 Enrollment ID: I20051206000835 |
| Provider Name | Hale Ersoy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386676385 PECOS PAC ID: 0840212601 Enrollment ID: I20051221000650 |
| Provider Name | Sanjay Kumar Pathak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831170083 PECOS PAC ID: 9436145356 Enrollment ID: I20060103000698 |
| Provider Name | Anitha Sadasivan Dasari |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770547879 PECOS PAC ID: 7012930381 Enrollment ID: I20060112000617 |
| Provider Name | Maria I Sannella |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407801004 PECOS PAC ID: 9931123528 Enrollment ID: I20060123000403 |
| Provider Name | Andrew J Deane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457333080 PECOS PAC ID: 1850315334 Enrollment ID: I20060124000125 |
| Provider Name | Vicki A Schwartz |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1336120229 PECOS PAC ID: 2567479678 Enrollment ID: I20060315000233 |
| Provider Name | Barry I Rosenblum |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1932148962 PECOS PAC ID: 5092723890 Enrollment ID: I20060404000765 |
| Provider Name | Edward F Hassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396784385 PECOS PAC ID: 7416920715 Enrollment ID: I20060405000621 |
| Provider Name | Stephen Pidgeon |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114902475 PECOS PAC ID: 1951310192 Enrollment ID: I20060417000134 |
| Provider Name | Laura A Griffin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104884600 PECOS PAC ID: 9537172853 Enrollment ID: I20060802000506 |
| Provider Name | Benjamin Hamar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003897877 PECOS PAC ID: 0547160269 Enrollment ID: I20060816000365 |
| Provider Name | Vikas Tewari |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639104664 PECOS PAC ID: 3476556051 Enrollment ID: I20060821000551 |
| Provider Name | Rachana Singh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881601433 PECOS PAC ID: 8820092711 Enrollment ID: I20060907000340 |
| Provider Name | Devi Vedula |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1922045665 PECOS PAC ID: 9739186313 Enrollment ID: I20061024000166 |
| Provider Name | Ali Reza Niakosari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750362331 PECOS PAC ID: 3779560354 Enrollment ID: I20061109000564 |
| Provider Name | Amy L Gurland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326050212 PECOS PAC ID: 4385746965 Enrollment ID: I20070228000440 |
| Provider Name | Jonathan M Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457386534 PECOS PAC ID: 6204939721 Enrollment ID: I20070321000173 |
| Provider Name | Coleen A Cummings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265567101 PECOS PAC ID: 5597869024 Enrollment ID: I20070322000444 |
| Provider Name | Christiane E Dammann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639395585 PECOS PAC ID: 1052418472 Enrollment ID: I20070521000051 |
| Provider Name | Walter J Grabowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518061043 PECOS PAC ID: 9032215835 Enrollment ID: I20070615000092 |
| Provider Name | Gregg A. Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902820756 PECOS PAC ID: 5395845135 Enrollment ID: I20070710000427 |
| Provider Name | Daniel A Werzanski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104023761 PECOS PAC ID: 3577664192 Enrollment ID: I20070726000721 |
| Provider Name | Mohamad El Zaru |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1366440794 PECOS PAC ID: 0244128577 Enrollment ID: I20070914000010 |
| Provider Name | Erika Mello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467576298 PECOS PAC ID: 5193761799 Enrollment ID: I20070920000619 |
| Provider Name | Navin K Kapur |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902959554 PECOS PAC ID: 2567550031 Enrollment ID: I20071116000138 |
| Provider Name | Saarah Arshad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659593887 PECOS PAC ID: 0446330112 Enrollment ID: I20080108000087 |
| Provider Name | Allyson Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639367253 PECOS PAC ID: 6103907548 Enrollment ID: I20080111000249 |
| Provider Name | Emily K Serrano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609066794 PECOS PAC ID: 3375624737 Enrollment ID: I20080111000399 |
| Provider Name | John Cavallo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619914322 PECOS PAC ID: 5092788398 Enrollment ID: I20080225000200 |
| Provider Name | Engel B Bido Santos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285810424 PECOS PAC ID: 7517037310 Enrollment ID: I20080605000609 |
| Provider Name | Lana Kordunsky |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1750397923 PECOS PAC ID: 8921006537 Enrollment ID: I20080709000311 |
| Provider Name | Daniel L Bohl |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477579795 PECOS PAC ID: 6204841851 Enrollment ID: I20080724000129 |
| Provider Name | George Poulos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215109103 PECOS PAC ID: 4284708793 Enrollment ID: I20080801000025 |
| Provider Name | George J Bonnevie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790738250 PECOS PAC ID: 4981773132 Enrollment ID: I20080805000308 |
| Provider Name | Robert Daly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578503181 PECOS PAC ID: 7315950896 Enrollment ID: I20080818000119 |
| Provider Name | Syed Imam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972789592 PECOS PAC ID: 2062588023 Enrollment ID: I20080828000109 |
| Provider Name | Syed M Tahir |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932248721 PECOS PAC ID: 8820164320 Enrollment ID: I20080908000202 |
| Provider Name | Nagaraj-setty Holalkere |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497881106 PECOS PAC ID: 5991871154 Enrollment ID: I20080911000721 |
| Provider Name | Lisa Salisbury |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346452638 PECOS PAC ID: 8123195062 Enrollment ID: I20080918000581 |
| Provider Name | Juan Pablo Richiusa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164614434 PECOS PAC ID: 9638247877 Enrollment ID: I20081001000457 |
| Provider Name | Borzoo Nikpoor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053586487 PECOS PAC ID: 0941378541 Enrollment ID: I20081009000422 |
| Provider Name | Elton Fennell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497705891 PECOS PAC ID: 7012950926 Enrollment ID: I20081010000243 |
| Provider Name | Robert D Crawford |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437130853 PECOS PAC ID: 6305904509 Enrollment ID: I20081016000265 |
| Provider Name | Simret B Tesfe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881879591 PECOS PAC ID: 8325107683 Enrollment ID: I20081101000078 |
| Provider Name | Baljinder Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760660492 PECOS PAC ID: 2062571706 Enrollment ID: I20081110000428 |
| Provider Name | Helen Le |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437358017 PECOS PAC ID: 8426144221 Enrollment ID: I20081117000327 |
| Provider Name | Henry J Grazioso |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154350825 PECOS PAC ID: 6002976057 Enrollment ID: I20081120000226 |
| Provider Name | Kerry M Girard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871541045 PECOS PAC ID: 3375607245 Enrollment ID: I20090122000176 |
| Provider Name | Kristin Ratliff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326010877 PECOS PAC ID: 1052475514 Enrollment ID: I20090127000741 |
| Provider Name | Rachel Fortes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083852263 PECOS PAC ID: 3375609191 Enrollment ID: I20090303000596 |
| Provider Name | Sean Sheeran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689627614 PECOS PAC ID: 4880763036 Enrollment ID: I20090504000245 |
| Provider Name | Kyung Hee Chang |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1598930398 PECOS PAC ID: 2668522574 Enrollment ID: I20090616000356 |
| Provider Name | Mark Greve |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710908611 PECOS PAC ID: 3173529450 Enrollment ID: I20090616000583 |
| Provider Name | Stephen Thomas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972575330 PECOS PAC ID: 5991880320 Enrollment ID: I20090623000194 |
| Provider Name | Troilus A Plante |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669496154 PECOS PAC ID: 8729083845 Enrollment ID: I20090716000596 |
| Provider Name | Mathews Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689790586 PECOS PAC ID: 1456404730 Enrollment ID: I20090804000451 |
| Provider Name | Alexander Georgakis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265697171 PECOS PAC ID: 4981624111 Enrollment ID: I20090824000345 |
| Provider Name | Marcin Sprycha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841455136 PECOS PAC ID: 5991850224 Enrollment ID: I20090909000668 |
| Provider Name | Daniel Babson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467659938 PECOS PAC ID: 2961549365 Enrollment ID: I20091016000101 |
| Provider Name | Tutasi K Waters |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073539334 PECOS PAC ID: 7911044953 Enrollment ID: I20091026000035 |
| Provider Name | Keith Merlin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659316701 PECOS PAC ID: 4486543949 Enrollment ID: I20091027000640 |
| Provider Name | Andrew D Stone |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497795561 PECOS PAC ID: 6002810207 Enrollment ID: I20091118000572 |
| Provider Name | Anupam M Desai |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1316126733 PECOS PAC ID: 7113069600 Enrollment ID: I20100121000487 |
| Provider Name | Donald F Kornack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962427039 PECOS PAC ID: 5597800680 Enrollment ID: I20100301000262 |
| Provider Name | Ellen Flynn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699803551 PECOS PAC ID: 9931236833 Enrollment ID: I20100426000177 |
| Provider Name | Alex A Teixeira |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700819224 PECOS PAC ID: 9931258746 Enrollment ID: I20100526000695 |
| Provider Name | Kara L Minnock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619293974 PECOS PAC ID: 7911038476 Enrollment ID: I20100627000009 |
| Provider Name | Daniel Feleke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598905630 PECOS PAC ID: 2062543077 Enrollment ID: I20100707000539 |
| Provider Name | Melissa M Mauro Small |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275507360 PECOS PAC ID: 6305978578 Enrollment ID: I20100723000345 |
| Provider Name | Divjot K Sooch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275731853 PECOS PAC ID: 3779608138 Enrollment ID: I20100909000295 |
| Provider Name | Jessie H Macvicar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912988874 PECOS PAC ID: 4385713999 Enrollment ID: I20100929000905 |
| Provider Name | Virginia O'connell Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467773622 PECOS PAC ID: 9032304548 Enrollment ID: I20101110000507 |
| Provider Name | Christiana Akanegbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659607398 PECOS PAC ID: 3274720750 Enrollment ID: I20101209000619 |
| Provider Name | Richard C Lords |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649296427 PECOS PAC ID: 4486842754 Enrollment ID: I20101230000800 |
| Provider Name | Renate Girard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134187198 PECOS PAC ID: 7214116094 Enrollment ID: I20110126000091 |
| Provider Name | Jennifer L Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083846760 PECOS PAC ID: 0648451393 Enrollment ID: I20110301000144 |
| Provider Name | Clayton T Wood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417121443 PECOS PAC ID: 7719155787 Enrollment ID: I20110718000414 |
| Provider Name | Nancy Mckinney |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1992765713 PECOS PAC ID: 6507937752 Enrollment ID: I20110802000613 |
| Provider Name | Alireza H Nezhad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689836868 PECOS PAC ID: 1557530466 Enrollment ID: I20110810000667 |
| Provider Name | Elad Anter |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891832499 PECOS PAC ID: 4385708700 Enrollment ID: I20110824000507 |
| Provider Name | Reve Shields |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1871719187 PECOS PAC ID: 1759551658 Enrollment ID: I20110901000514 |
| Provider Name | Stephen Maloney |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1932369246 PECOS PAC ID: 0840460564 Enrollment ID: I20110907000767 |
| Provider Name | Garrey T Faller |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1407844228 PECOS PAC ID: 2961673009 Enrollment ID: I20110921000009 |
| Provider Name | John Scott Steinmetz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740215961 PECOS PAC ID: 7113192469 Enrollment ID: I20111214000912 |
| Provider Name | Maryann V Volpe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326150871 PECOS PAC ID: 2567638596 Enrollment ID: I20111222000056 |
| Provider Name | Federico Martinez |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992862486 PECOS PAC ID: 8123294162 Enrollment ID: I20111222000158 |
| Provider Name | Julie B Kastner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891001053 PECOS PAC ID: 4183806573 Enrollment ID: I20120118000005 |
| Provider Name | Gregory W Woo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093910788 PECOS PAC ID: 0547420325 Enrollment ID: I20120402000605 |
| Provider Name | Sara I Lozano |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902021884 PECOS PAC ID: 9830259472 Enrollment ID: I20120504000567 |
| Provider Name | Aileen A Abesamis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619056546 PECOS PAC ID: 9830351766 Enrollment ID: I20120510000056 |
| Provider Name | Amy Mondelblatt |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1225288459 PECOS PAC ID: 7012171168 Enrollment ID: I20120621000149 |
| Provider Name | James T Mcphee |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1962460360 PECOS PAC ID: 1951566678 Enrollment ID: I20120703000206 |
| Provider Name | Brandon K Tari |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992826408 PECOS PAC ID: 0345492278 Enrollment ID: I20121128000615 |
| Provider Name | Nadalee M Angelos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790078863 PECOS PAC ID: 6709039563 Enrollment ID: I20130104000189 |
| Provider Name | Olivera Boskovska |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811980931 PECOS PAC ID: 1850339961 Enrollment ID: I20130205000575 |
| Provider Name | Georges S Almacari |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326152216 PECOS PAC ID: 8123279437 Enrollment ID: I20130304000300 |
| Provider Name | Mark Bobbin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639422637 PECOS PAC ID: 1951540434 Enrollment ID: I20130612000662 |
| Provider Name | Gopakumar S Sreekumaran Nair |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811201841 PECOS PAC ID: 8527206994 Enrollment ID: I20130701000113 |
| Provider Name | Remya Tharackal Ravindran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639476690 PECOS PAC ID: 8325288459 Enrollment ID: I20130712000233 |
| Provider Name | Raneem Islam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366672115 PECOS PAC ID: 3173765559 Enrollment ID: I20130814000688 |
| Provider Name | Michelle Martin |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1881878148 PECOS PAC ID: 5597909390 Enrollment ID: I20130918000058 |
| Provider Name | Sarah Maria Lawson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629394101 PECOS PAC ID: 4486888583 Enrollment ID: I20131003000160 |
| Provider Name | Jaclyn R Boulais |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750602496 PECOS PAC ID: 8921233685 Enrollment ID: I20131105000807 |
| Provider Name | Ronald T Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841443470 PECOS PAC ID: 0547490179 Enrollment ID: I20140227001558 |
| Provider Name | Adrea S. Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275795478 PECOS PAC ID: 2062660087 Enrollment ID: I20140228001193 |
| Provider Name | Ruggero Spadafora |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821312893 PECOS PAC ID: 4688832363 Enrollment ID: I20140324000952 |
| Provider Name | Kimberly A Moniz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558794651 PECOS PAC ID: 7618108887 Enrollment ID: I20140401001883 |
| Provider Name | Kenneth A. Frausto |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831403054 PECOS PAC ID: 3678734472 Enrollment ID: I20140509001879 |
| Provider Name | Norah R Emara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548557192 PECOS PAC ID: 6103041934 Enrollment ID: I20140710001039 |
| Provider Name | Serena M Jiddou |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396056826 PECOS PAC ID: 8325264732 Enrollment ID: I20140721001651 |
| Provider Name | Genny I Wolf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659665909 PECOS PAC ID: 5092932780 Enrollment ID: I20140804000381 |
| Provider Name | Deepti Seshadri |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1821249566 PECOS PAC ID: 3072745900 Enrollment ID: I20141212001280 |
| Provider Name | Philippe Vuylsteke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679587356 PECOS PAC ID: 6507933249 Enrollment ID: I20150109001497 |
| Provider Name | Natasha B Khazai |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1114927670 PECOS PAC ID: 6608807714 Enrollment ID: I20150203001914 |
| Provider Name | Jill Pratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841694478 PECOS PAC ID: 8628393386 Enrollment ID: I20150221000073 |
| Provider Name | Shahenda Aly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982993747 PECOS PAC ID: 4183940281 Enrollment ID: I20150309001557 |
| Provider Name | Suresh Gundaji |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467662601 PECOS PAC ID: 1052457702 Enrollment ID: I20150326001517 |
| Provider Name | Aleksandra Tereszkiewicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740421924 PECOS PAC ID: 6103143060 Enrollment ID: I20150402001614 |
| Provider Name | Jona S Dunphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265832919 PECOS PAC ID: 3173841913 Enrollment ID: I20150408000137 |
| Provider Name | Theresa M Russo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972904506 PECOS PAC ID: 1153649470 Enrollment ID: I20150417000728 |
| Provider Name | Divya Koster |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073694147 PECOS PAC ID: 3678892437 Enrollment ID: I20150430000033 |
| Provider Name | Brenda J Fernandes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972901569 PECOS PAC ID: 1557682366 Enrollment ID: I20150605000051 |
| Provider Name | Jonathan W Waks |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467611640 PECOS PAC ID: 8224340898 Enrollment ID: I20150710000252 |
| Provider Name | Nisha M David |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851689988 PECOS PAC ID: 9436381118 Enrollment ID: I20150710000533 |
| Provider Name | Megan J Mcnamara |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508081498 PECOS PAC ID: 3870674518 Enrollment ID: I20150806010021 |
| Provider Name | Roy Bryan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396021648 PECOS PAC ID: 7113171240 Enrollment ID: I20150812008003 |
| Provider Name | Anna P Roland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770993727 PECOS PAC ID: 9739401167 Enrollment ID: I20150825003554 |
| Provider Name | Ian Michael Wu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1528225745 PECOS PAC ID: 8325199573 Enrollment ID: I20150923001886 |
| Provider Name | Jennifer Lynne Guerra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679957153 PECOS PAC ID: 6002124385 Enrollment ID: I20151006002961 |
| Provider Name | George Ganson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942490115 PECOS PAC ID: 9931365632 Enrollment ID: I20151008001715 |
| Provider Name | Imane T Bentahar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245488105 PECOS PAC ID: 9133297880 Enrollment ID: I20151019000755 |
| Provider Name | Marc Scott Spiegel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104180595 PECOS PAC ID: 4284944356 Enrollment ID: I20151103000710 |
| Provider Name | Grace A Snell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1851773576 PECOS PAC ID: 8527369479 Enrollment ID: I20151217001292 |
| Provider Name | Amanda C Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841541109 PECOS PAC ID: 6608091327 Enrollment ID: I20160108002202 |
| Provider Name | Monique Tasker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114209905 PECOS PAC ID: 5496059479 Enrollment ID: I20160211001935 |
| Provider Name | Reza Fazel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881795730 PECOS PAC ID: 9234106188 Enrollment ID: I20160321002075 |
| Provider Name | Patricia A Wesley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730548579 PECOS PAC ID: 8224335005 Enrollment ID: I20160322000912 |
| Provider Name | Sharobi A Dutta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689014805 PECOS PAC ID: 5799077921 Enrollment ID: I20160708001410 |
| Provider Name | Eugene Yoshio Fukudome |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083740401 PECOS PAC ID: 3971766510 Enrollment ID: I20161018002885 |
| Provider Name | Rena B Levy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013325661 PECOS PAC ID: 0749568996 Enrollment ID: I20161024001123 |
| Provider Name | Edmundo Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710384896 PECOS PAC ID: 4082993357 Enrollment ID: I20161110000377 |
| Provider Name | Melisa Anne Poulos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497076632 PECOS PAC ID: 4082846324 Enrollment ID: I20170208002210 |
| Provider Name | Kinjal Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306134978 PECOS PAC ID: 0840512901 Enrollment ID: I20170414000565 |
| Provider Name | Inna Baran |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457798563 PECOS PAC ID: 1557589009 Enrollment ID: I20170629001514 |
| Provider Name | Kellyann G. Florentino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649703547 PECOS PAC ID: 4486924966 Enrollment ID: I20170717000167 |
| Provider Name | Andrew H Locke |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1922445055 PECOS PAC ID: 0840508644 Enrollment ID: I20170717000474 |
| Provider Name | Kevin Raymond Gendreau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023422607 PECOS PAC ID: 4082903182 Enrollment ID: I20170809000382 |
| Provider Name | Lina Rios |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104250380 PECOS PAC ID: 2365715844 Enrollment ID: I20170905001939 |
| Provider Name | Eduardo Moraes Leao Peixoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124433347 PECOS PAC ID: 6709152291 Enrollment ID: I20171028000238 |
| Provider Name | Stephanie Pine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386163533 PECOS PAC ID: 9032476536 Enrollment ID: I20171207001683 |
| Provider Name | Jamie A Folan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962954560 PECOS PAC ID: 0143503961 Enrollment ID: I20180328002627 |
| Provider Name | Justin E Vandenbosch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265972665 PECOS PAC ID: 3678837705 Enrollment ID: I20180426000274 |
| Provider Name | Kelly Rose Bowen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174920557 PECOS PAC ID: 7012271299 Enrollment ID: I20180516001981 |
| Provider Name | Jim Y Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568705358 PECOS PAC ID: 8921225673 Enrollment ID: I20180605002455 |
| Provider Name | Lilizita Monteiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811440506 PECOS PAC ID: 6103173984 Enrollment ID: I20180725001305 |
| Provider Name | Temitope P Awosogba |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003235326 PECOS PAC ID: 0143448001 Enrollment ID: I20180827000368 |
| Provider Name | Luei Wern Ong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841670536 PECOS PAC ID: 6305135468 Enrollment ID: I20180904000523 |
| Provider Name | Marina Khait |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205266962 PECOS PAC ID: 7214287416 Enrollment ID: I20180910002056 |
| Provider Name | Katelyn Marie Sullivan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205220720 PECOS PAC ID: 2567775331 Enrollment ID: I20180913001863 |
| Provider Name | Natalia M Marks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922310002 PECOS PAC ID: 0345532446 Enrollment ID: I20180928001341 |
| Provider Name | Neha Chaudhary |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811371123 PECOS PAC ID: 0648522466 Enrollment ID: I20181005001625 |
| Provider Name | Savina Jaggi Yee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164921342 PECOS PAC ID: 9335492339 Enrollment ID: I20181022000153 |
| Provider Name | Edward Walter Malin |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1871751180 PECOS PAC ID: 6608034129 Enrollment ID: I20181210000901 |
| Provider Name | Stephanie Macleay |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497234108 PECOS PAC ID: 0648515411 Enrollment ID: I20181224000375 |
| Provider Name | Gregory Pamphile |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629426390 PECOS PAC ID: 2961747464 Enrollment ID: I20190102000916 |
| Provider Name | Leena Mayuresh Rajwadkar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083933550 PECOS PAC ID: 7911243381 Enrollment ID: I20190107003003 |
| Provider Name | Aliya Zul Jiwani |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1417218397 PECOS PAC ID: 9032353750 Enrollment ID: I20190116003630 |
| Provider Name | Joan B Keel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942531934 PECOS PAC ID: 8921135401 Enrollment ID: I20190319000733 |
| Provider Name | Sarika Chopra |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518288315 PECOS PAC ID: 7113231655 Enrollment ID: I20190402000814 |
| Provider Name | Arthur Reshad Garan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518142306 PECOS PAC ID: 3678628161 Enrollment ID: I20190402001231 |
| Provider Name | Asim H Maher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619215167 PECOS PAC ID: 1557616968 Enrollment ID: I20190424002277 |
| Provider Name | Ernesto G Gonzalez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215321765 PECOS PAC ID: 4688911043 Enrollment ID: I20190624001769 |
| Provider Name | Ryan Joseph O'hara |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265810782 PECOS PAC ID: 7719288414 Enrollment ID: I20190626003638 |
| Provider Name | Jin Yuan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1710368493 PECOS PAC ID: 0648519355 Enrollment ID: I20190715002045 |
| Provider Name | Anuradha M Bhimavarapu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447207691 PECOS PAC ID: 6507192069 Enrollment ID: I20190723000409 |
| Provider Name | Anthony E. Kraus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790130888 PECOS PAC ID: 2668708934 Enrollment ID: I20190724001443 |
| Provider Name | Maulshree Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740621051 PECOS PAC ID: 3779870464 Enrollment ID: I20190905001242 |
| Provider Name | Thomas L Devries |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518353820 PECOS PAC ID: 2062718455 Enrollment ID: I20191022001753 |
| Provider Name | Luke Addison Stevens |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477949287 PECOS PAC ID: 5193027217 Enrollment ID: I20191204002670 |
| Provider Name | Milinda Ruth Carson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275572034 PECOS PAC ID: 6305804659 Enrollment ID: I20191213000088 |
| Provider Name | Jennifer S Goldblatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194374751 PECOS PAC ID: 5597192369 Enrollment ID: I20200218000840 |
| Provider Name | Katelyn Michelle Pento |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164067831 PECOS PAC ID: 0143658484 Enrollment ID: I20200319001094 |
| Provider Name | Christine M Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285288746 PECOS PAC ID: 2466881875 Enrollment ID: I20200407000759 |
| Provider Name | Jalal Mukhtar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1861780090 PECOS PAC ID: 5395961015 Enrollment ID: I20200506000860 |
| Provider Name | Irene Gianiotis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831590595 PECOS PAC ID: 4486974243 Enrollment ID: I20200506001430 |
| Provider Name | Colton Margus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396276069 PECOS PAC ID: 4486990322 Enrollment ID: I20200522002026 |
| Provider Name | Byron Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649652603 PECOS PAC ID: 6305183229 Enrollment ID: I20200608001202 |
| Provider Name | Jason Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982639621 PECOS PAC ID: 6204721251 Enrollment ID: I20200729002194 |
| Provider Name | Sapan Gandhi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578975538 PECOS PAC ID: 5799900882 Enrollment ID: I20200807001704 |
| Provider Name | Matthew Lambton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942662937 PECOS PAC ID: 8123444080 Enrollment ID: I20200821002685 |
| Provider Name | Ramses M Thabet |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689014284 PECOS PAC ID: 9638597222 Enrollment ID: I20200914002404 |
| Provider Name | Ali Jon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184035693 PECOS PAC ID: 2062831936 Enrollment ID: I20200925000561 |
| Provider Name | Sarah J Carlson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1093952939 PECOS PAC ID: 4688967151 Enrollment ID: I20201106001843 |
| Provider Name | Abena Darkwaa Hagan-brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487185773 PECOS PAC ID: 6103236575 Enrollment ID: I20201113002195 |
| Provider Name | Kara Marie Le |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396367595 PECOS PAC ID: 8123439924 Enrollment ID: I20201130002918 |
| Provider Name | Caroline Anne Naylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922619170 PECOS PAC ID: 4981017571 Enrollment ID: I20201228000617 |
| Provider Name | Jennifer Teixeira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174145841 PECOS PAC ID: 4284047994 Enrollment ID: I20210119000745 |
| Provider Name | Adam S Donahue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356951784 PECOS PAC ID: 6305250051 Enrollment ID: I20210121000120 |
| Provider Name | Arvind K Gireesh |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316108798 PECOS PAC ID: 6507143740 Enrollment ID: I20210127003541 |
| Provider Name | Kacey Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932726957 PECOS PAC ID: 1153736434 Enrollment ID: I20210218001994 |
| Provider Name | Raghava S Velagaleti |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326133315 PECOS PAC ID: 5597868430 Enrollment ID: I20210226000457 |
| Provider Name | Randa I Mougarbel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144729344 PECOS PAC ID: 1355683723 Enrollment ID: I20210413000709 |
| Provider Name | Kanneganti Divya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861912511 PECOS PAC ID: 6305254905 Enrollment ID: I20210420002539 |
| Provider Name | Steven Milman |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1588821078 PECOS PAC ID: 4385799964 Enrollment ID: I20210507000331 |
| Provider Name | James Gottschall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144683194 PECOS PAC ID: 1759676349 Enrollment ID: I20210616001866 |
| Provider Name | Samantha Montigny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609371061 PECOS PAC ID: 5799185401 Enrollment ID: I20210617001780 |
| Provider Name | Jerry Chi Chuan Fang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1437413242 PECOS PAC ID: 8820396070 Enrollment ID: I20210622001814 |
| Provider Name | Christina A Woodward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881951226 PECOS PAC ID: 8820385255 Enrollment ID: I20210622003697 |
| Provider Name | Akshay B Shanbhag |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831610559 PECOS PAC ID: 7719388024 Enrollment ID: I20210624000536 |
| Provider Name | Alfred John Reyes Tanglao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235633785 PECOS PAC ID: 6507267531 Enrollment ID: I20210629001245 |
| Provider Name | Tanit Phupitakphol |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487005062 PECOS PAC ID: 6305187519 Enrollment ID: I20210702002467 |
| Provider Name | Margot P Whitney |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699346676 PECOS PAC ID: 9133522923 Enrollment ID: I20210731000021 |
| Provider Name | John Acord |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013531086 PECOS PAC ID: 2961806369 Enrollment ID: I20210806002277 |
| Provider Name | Lori E Marshall |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558035063 PECOS PAC ID: 0143625723 Enrollment ID: I20210819001787 |
| Provider Name | Trinley Gongya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487149530 PECOS PAC ID: 3971909516 Enrollment ID: I20210908001218 |
| Provider Name | Abdallah Azouz |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1336366293 PECOS PAC ID: 1850560467 Enrollment ID: I20210922002056 |
| Provider Name | Karen L Bugaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871894733 PECOS PAC ID: 8729060538 Enrollment ID: I20211029001024 |
| Provider Name | Raj A Gadhia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922368976 PECOS PAC ID: 9537455076 Enrollment ID: I20211104001225 |
| Provider Name | Brenda Nunes Ruskey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366921298 PECOS PAC ID: 2466841507 Enrollment ID: I20211111001805 |
| Provider Name | Juliana Bahia Mazzafera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588152631 PECOS PAC ID: 8426446543 Enrollment ID: I20211207001260 |
| Provider Name | Laura Ann White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316555741 PECOS PAC ID: 3870984032 Enrollment ID: I20211222001616 |
| Provider Name | Ifeoma Laurietta Ugbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720698442 PECOS PAC ID: 5698167815 Enrollment ID: I20220120002618 |
| Provider Name | Lindsay M Mcgrath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083380893 PECOS PAC ID: 8820483829 Enrollment ID: I20220309001591 |
| Provider Name | Hendy Jean |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063823193 PECOS PAC ID: 7012287758 Enrollment ID: I20220317001533 |
| Provider Name | Larry V Lee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497049753 PECOS PAC ID: 2466751235 Enrollment ID: I20220323000929 |
| Provider Name | Elliott C. Fox |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467915520 PECOS PAC ID: 8820324098 Enrollment ID: I20220428000263 |
| Provider Name | Ihuoma I Arikibe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942805338 PECOS PAC ID: 3375930902 Enrollment ID: I20220428001136 |
| Provider Name | Ilyas Yambayev |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1457882557 PECOS PAC ID: 0244501047 Enrollment ID: I20220525000795 |
| Provider Name | Arthur Celestin |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1043574288 PECOS PAC ID: 2961777214 Enrollment ID: I20220608002284 |
| Provider Name | Jason Lou |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1649621442 PECOS PAC ID: 5395148464 Enrollment ID: I20220617001419 |
| Provider Name | Brooke Krbec |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568824696 PECOS PAC ID: 6901197722 Enrollment ID: I20220622002344 |
| Provider Name | Christopher T Lim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902300932 PECOS PAC ID: 3577811744 Enrollment ID: I20220725000821 |
| Provider Name | Soheila Talebi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265846406 PECOS PAC ID: 0749516433 Enrollment ID: I20220728002187 |
| Provider Name | Syeda Mariam Qamar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356836894 PECOS PAC ID: 7911316203 Enrollment ID: I20220823003451 |
| Provider Name | Xin He |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1033590229 PECOS PAC ID: 2567779309 Enrollment ID: I20220824002611 |
| Provider Name | Kristine Ulip |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1952049512 PECOS PAC ID: 4183008881 Enrollment ID: I20220830001420 |
| Provider Name | Natalie J Laubach |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1659044758 PECOS PAC ID: 0345635397 Enrollment ID: I20220902002328 |
| Provider Name | Marie Nathalie E Saintil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750941613 PECOS PAC ID: 4789082942 Enrollment ID: I20220913003140 |
| Provider Name | Sheila Tohmc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881202588 PECOS PAC ID: 7810366267 Enrollment ID: I20221207002249 |
| Provider Name | Emad Awa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336408723 PECOS PAC ID: 8729457437 Enrollment ID: I20221219001856 |
| Provider Name | Anna J Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417517855 PECOS PAC ID: 8820324262 Enrollment ID: I20221220002767 |
| Provider Name | Sara E Hall |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1295384717 PECOS PAC ID: 8729458898 Enrollment ID: I20230105002758 |
| Provider Name | Dawn Dawson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073571857 PECOS PAC ID: 4981882164 Enrollment ID: I20230202001147 |
| Provider Name | Alyssa L White |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1518664580 PECOS PAC ID: 4486027869 Enrollment ID: I20230306001737 |
| Provider Name | Loving Ihenacho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255051363 PECOS PAC ID: 5092188490 Enrollment ID: I20230306002602 |
| Provider Name | Lauren Kathleen O'connor |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477162949 PECOS PAC ID: 3577936707 Enrollment ID: I20230308002334 |
| Provider Name | Tayla Marie Carter |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295486892 PECOS PAC ID: 3476926544 Enrollment ID: I20230310002001 |
| Provider Name | Lindsay Schwartz |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1790482644 PECOS PAC ID: 6507239688 Enrollment ID: I20230310002364 |
| Provider Name | Suvekchha Devkota |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316294929 PECOS PAC ID: 2062729718 Enrollment ID: I20230317000413 |
| Provider Name | Gregory Goldstein |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679985592 PECOS PAC ID: 4284851833 Enrollment ID: I20230413001221 |
| Provider Name | Cara O'keefe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578013520 PECOS PAC ID: 9032574132 Enrollment ID: I20230425000726 |
| Provider Name | Kady A Bonica |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578272621 PECOS PAC ID: 9133584196 Enrollment ID: I20230426000432 |
| Provider Name | Grace Ma |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801388855 PECOS PAC ID: 3779830930 Enrollment ID: I20230427000614 |
| Provider Name | Anna R Whelan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922497874 PECOS PAC ID: 7214223940 Enrollment ID: I20230503003397 |
| Provider Name | Henry Lin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124092085 PECOS PAC ID: 8224251830 Enrollment ID: I20230515001645 |
| Provider Name | Vijaya T. Daniel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922426915 PECOS PAC ID: 9234355470 Enrollment ID: I20230531003567 |
| Provider Name | Artem Shevtsov |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891202990 PECOS PAC ID: 0143582478 Enrollment ID: I20230615001690 |
| Provider Name | Ashley Leer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952066946 PECOS PAC ID: 0143688176 Enrollment ID: I20230622002227 |
| Provider Name | Dhrumil K Patel |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1518429521 PECOS PAC ID: 9436485604 Enrollment ID: I20230713001741 |
| Provider Name | Patricia Noelia Bido |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740819150 PECOS PAC ID: 7113388372 Enrollment ID: I20230803002740 |
| Provider Name | James K Choi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851827976 PECOS PAC ID: 6608237698 Enrollment ID: I20230808000416 |
| Provider Name | Ryan M Carter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720254006 PECOS PAC ID: 8426104621 Enrollment ID: I20230809003782 |
| Provider Name | Mohammed Al Qaraghouli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134650138 PECOS PAC ID: 5395084040 Enrollment ID: I20230814002834 |
| Provider Name | Michael John Zujkowski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598112591 PECOS PAC ID: 0840584199 Enrollment ID: I20230821000384 |
| Provider Name | Sabrina Johar |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1710459193 PECOS PAC ID: 9234592999 Enrollment ID: I20230828003474 |
| Provider Name | Kevin A Buczkowski |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1891316477 PECOS PAC ID: 9234592791 Enrollment ID: I20230830003954 |
| Provider Name | Nuvair Imam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558989491 PECOS PAC ID: 7416374350 Enrollment ID: I20230901001978 |
| Provider Name | Misti M Coronel |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1124345657 PECOS PAC ID: 1658502745 Enrollment ID: I20231025001129 |
| Provider Name | Kristen Klemmer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225650369 PECOS PAC ID: 3375974900 Enrollment ID: I20231031000473 |
| Provider Name | Harish Panicker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639161847 PECOS PAC ID: 6103891767 Enrollment ID: I20231221003927 |
| Provider Name | Jennifer L Gudmundsson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295507549 PECOS PAC ID: 1951751346 Enrollment ID: I20231227002757 |
| Provider Name | Bruneli Almeida Degraca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063854545 PECOS PAC ID: 2466802491 Enrollment ID: I20240103000681 |
| Provider Name | Jacquelyn Dolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700535614 PECOS PAC ID: 3476912668 Enrollment ID: I20240125000631 |
| Provider Name | Victoria A Adewale |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467015024 PECOS PAC ID: 1052647344 Enrollment ID: I20240129001811 |
| Provider Name | Katelyn Mcsweeney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043809338 PECOS PAC ID: 9335587468 Enrollment ID: I20240409000698 |
| Provider Name | Debra J Gaves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063501765 PECOS PAC ID: 6800830654 Enrollment ID: I20240409004279 |
| Provider Name | Aaron Amardey-wellington |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073191953 PECOS PAC ID: 1759627532 Enrollment ID: I20240429001048 |
| Provider Name | Sophia Gorgens |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538685193 PECOS PAC ID: 0840658407 Enrollment ID: I20240430003667 |
| Provider Name | John Volpe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073136198 PECOS PAC ID: 9638590623 Enrollment ID: I20240501003672 |
| Provider Name | Kelsea Macneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699474247 PECOS PAC ID: 7810338274 Enrollment ID: I20240516000386 |
| Provider Name | John M Mitko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023495520 PECOS PAC ID: 7416371497 Enrollment ID: I20240624003425 |
| Provider Name | Amit Boukai |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730769472 PECOS PAC ID: 4183168453 Enrollment ID: I20240627001299 |
| Provider Name | James Dickerson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023004512 PECOS PAC ID: 9830130996 Enrollment ID: I20240627001673 |
| Provider Name | Thomas E. Rogers |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1780607796 PECOS PAC ID: 2163400615 Enrollment ID: I20240628002762 |
| Provider Name | Kyle Deerwester |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134624018 PECOS PAC ID: 0143765073 Enrollment ID: I20240715003617 |
| Provider Name | Nicole Alison Schick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508388091 PECOS PAC ID: 3678018504 Enrollment ID: I20240715003688 |
| Provider Name | Christopher Guarino |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780427914 PECOS PAC ID: 7911442843 Enrollment ID: I20240715003792 |
| Provider Name | Shaun Antonio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245811603 PECOS PAC ID: 4880048958 Enrollment ID: I20240722000026 |
| Provider Name | Eugene Louie-ng |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164476818 PECOS PAC ID: 9537176417 Enrollment ID: I20240723002864 |
| Provider Name | Kristin Leigh Hauvuy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013603265 PECOS PAC ID: 9436695566 Enrollment ID: I20240724003240 |
| Provider Name | Christ-ann Magloire |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093780207 PECOS PAC ID: 1153382452 Enrollment ID: I20240726001320 |
| Provider Name | Predrag Latkovich |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356313845 PECOS PAC ID: 3870658768 Enrollment ID: I20240806004448 |
| Provider Name | Shella Mongia |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1447458997 PECOS PAC ID: 4082871272 Enrollment ID: I20240807000650 |
| Provider Name | Muhammad Khokhar |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1780979963 PECOS PAC ID: 5395970461 Enrollment ID: I20240809003800 |
| Provider Name | Atilano Lacson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1811947757 PECOS PAC ID: 6507216405 Enrollment ID: I20240816002420 |
| Provider Name | Antonia Calabro-payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528284460 PECOS PAC ID: 7315130580 Enrollment ID: I20240904002580 |
| Provider Name | Susan Zelenak |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1407570344 PECOS PAC ID: 2567902133 Enrollment ID: I20240910001663 |
| Provider Name | Rajeshwari Kalyanaraman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912528332 PECOS PAC ID: 4183155823 Enrollment ID: I20241004000890 |
| Provider Name | Karla Kuusisto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437371051 PECOS PAC ID: 9234213869 Enrollment ID: I20241009003480 |
| Provider Name | Sarah Mcelroy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437815230 PECOS PAC ID: 9638600026 Enrollment ID: I20241009003972 |
| Provider Name | Ebla Abd Alrahman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255966743 PECOS PAC ID: 0446639942 Enrollment ID: I20241011002823 |
| Provider Name | Julio Alvarado Diaz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548907207 PECOS PAC ID: 9335597012 Enrollment ID: I20241206003092 |
Arbour Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9 Shaw Rd, Brockton, MA 02301 Phone: 617-935-4872 | |
Aubrey Lieberman Md Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1342 Belmont St, Suite 105, Brockton, MA 02301 Phone: 508-580-3330 Fax: 508-580-8633 | |
Bmc Community Hospital Corporation Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 235 N Pearl St, Brockton, MA 02301 Phone: 508-427-3000 | |
Brockton Multi Service Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 165 Quincy St, Dmh, Brockton, MA 02302 Phone: 508-897-2000 Fax: 508-586-5117 |