| Vista Medical Services, Inc. | |
|
160 Rock Hill Rd Fl 1 Bala Cynwyd PA 19004-2133 | |
| (610) 667-6080 | |
| (610) 668-1580 |
| Full Name | Vista Medical Services, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 160 Rock Hill Rd Fl 1, Bala Cynwyd, Pennsylvania |
| Authorized Official Name and Position | Larry Durlofsky (PRESIDENT) |
| Authorized Official Contact | 3025987667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Medical Services, Inc. 160 Rock Hill Rd Fl 1 Bala Cynwyd PA 19004-2133 Ph: (610) 667-6080 | Vista Medical Services, Inc. 160 Rock Hill Rd Fl 1 Bala Cynwyd PA 19004-2133 Ph: (610) 667-6080 |
| NPI Number | 1659452027 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 07/11/2013 |
| Medicare PECOS PAC ID | 5597743344 |
|---|---|
| Medicare Enrollment ID | O20040709000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659452027 | NPI | - | NPPES |
| 0001045604 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Deborah J Buck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386861979 PECOS PAC ID: 7618932310 Enrollment ID: I20041122000957 |
| Provider Name | Rachel Hannah Saks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710052345 PECOS PAC ID: 2567476757 Enrollment ID: I20060126000797 |
| Provider Name | Jennifer Coates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366521593 PECOS PAC ID: 2860494978 Enrollment ID: I20070202000126 |
| Provider Name | Amy C Lockwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265508477 PECOS PAC ID: 7012013535 Enrollment ID: I20070430000502 |
| Provider Name | Lori A Ruskin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053591503 PECOS PAC ID: 8224128079 Enrollment ID: I20071217000327 |
| Provider Name | Galina Kshik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952476079 PECOS PAC ID: 1951480946 Enrollment ID: I20080501000527 |
| Provider Name | Gail K Elliot |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891987095 PECOS PAC ID: 1052462017 Enrollment ID: I20090702000298 |
| Provider Name | Larry Durlofsky |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1720169188 PECOS PAC ID: 8527088731 Enrollment ID: I20101124000409 |
| Provider Name | Birgit A Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710204664 PECOS PAC ID: 4082893375 Enrollment ID: I20110119000123 |
| Provider Name | Linda R Weinberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457403743 PECOS PAC ID: 7517033400 Enrollment ID: I20110209001050 |
| Provider Name | John M Uveges |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205816907 PECOS PAC ID: 2567552938 Enrollment ID: I20110525000231 |
| Provider Name | Diana L Vanhouten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811275480 PECOS PAC ID: 2668642075 Enrollment ID: I20110823000151 |
| Provider Name | Susan Fralick-ball |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053696161 PECOS PAC ID: 2769657600 Enrollment ID: I20111206000079 |
| Provider Name | Darren L Whaley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023352044 PECOS PAC ID: 8729216148 Enrollment ID: I20140110000631 |
| Provider Name | Christine Mcguire |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225130149 PECOS PAC ID: 4284851494 Enrollment ID: I20140812002217 |
| Provider Name | Jenika L Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255503892 PECOS PAC ID: 7113249855 Enrollment ID: I20141208000595 |
| Provider Name | Anzhela Kogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871865899 PECOS PAC ID: 4688991912 Enrollment ID: I20150326000834 |
| Provider Name | Hallie Katrina Dennison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568852358 PECOS PAC ID: 5890015317 Enrollment ID: I20151002001856 |
| Provider Name | Lyuba Mereminsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730567793 PECOS PAC ID: 7719106566 Enrollment ID: I20151014000247 |
| Provider Name | Mary R Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366834855 PECOS PAC ID: 8224331129 Enrollment ID: I20160127001537 |
| Provider Name | Ruth Sampson Pilgrim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295181717 PECOS PAC ID: 1456641315 Enrollment ID: I20160606000235 |
| Provider Name | Sheela Korah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215383369 PECOS PAC ID: 7416247408 Enrollment ID: I20161017000190 |
| Provider Name | Ann Marie T Storbrauck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417142514 PECOS PAC ID: 4880974187 Enrollment ID: I20161202000574 |
| Provider Name | Isabella A Tembe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518406131 PECOS PAC ID: 9739456088 Enrollment ID: I20170517001454 |
| Provider Name | Oluwadamilola Fowowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760838783 PECOS PAC ID: 5890077184 Enrollment ID: I20171027001804 |
| Provider Name | Lilian U Ogujiofor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255635058 PECOS PAC ID: 2860612215 Enrollment ID: I20171106000244 |
| Provider Name | Shelagh B Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477592517 PECOS PAC ID: 4385706001 Enrollment ID: I20171229000562 |
| Provider Name | John Devine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487177366 PECOS PAC ID: 0244599959 Enrollment ID: I20180125000443 |
| Provider Name | Jennifer R Olszewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750723250 PECOS PAC ID: 3577826650 Enrollment ID: I20180425000099 |
| Provider Name | Dehcontee Guar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730654278 PECOS PAC ID: 2163766031 Enrollment ID: I20181204000335 |
| Provider Name | Olamide Vincent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013474238 PECOS PAC ID: 9638592363 Enrollment ID: I20200714000096 |
| Provider Name | Thomas Koste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992324016 PECOS PAC ID: 9234556226 Enrollment ID: I20200908000573 |
| Provider Name | Argine Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992465736 PECOS PAC ID: 9931594330 Enrollment ID: I20220322001799 |
| Provider Name | Raquel Reid-robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740924836 PECOS PAC ID: 5193103760 Enrollment ID: I20220610000141 |
| Provider Name | Symphorien Andre Kamanou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508529918 PECOS PAC ID: 1052789880 Enrollment ID: I20221128002778 |
| Provider Name | Shannan N Harkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255046546 PECOS PAC ID: 0547633679 Enrollment ID: I20230310000287 |
| Provider Name | Ralph Rios |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093397051 PECOS PAC ID: 7416312459 Enrollment ID: I20230427000372 |
| Provider Name | Melisa R Kenner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477288926 PECOS PAC ID: 0648637314 Enrollment ID: I20230612001821 |
| Provider Name | Gina L Chester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851085625 PECOS PAC ID: 0941660666 Enrollment ID: I20230713000803 |
| Provider Name | Oluyemi Olaore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144913427 PECOS PAC ID: 2163883539 Enrollment ID: I20230801003525 |
| Provider Name | Aleta A Cohn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568199776 PECOS PAC ID: 1456706746 Enrollment ID: I20231005002511 |
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