| Wellcare Physicians Group, Llc | |
|
100 Morse St Norwood MA 02062 | |
| (781) 769-8700 | |
| (781) 769-8704 |
| Full Name | Wellcare Physicians Group, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 100 Morse St, Norwood, Massachusetts |
| Authorized Official Name and Position | Emily Coffey Deans (PARTNER) |
| Authorized Official Contact | 7817698700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellcare Physicians Group, Llc 100 Morse St Norwood MA 02062 Ph: (781) 769-8700 | Wellcare Physicians Group, Llc 100 Morse St Norwood MA 02062 Ph: (781) 769-8700 |
| NPI Number | 1033342043 |
|---|---|
| Provider Enumeration Date | 08/25/2009 |
| Last Update Date | 04/27/2012 |
| Medicare PECOS PAC ID | 0648317552 |
|---|---|
| Medicare Enrollment ID | O20091027000076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033342043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 218039 (Massachusetts) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Karen E Trevisan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720018039 PECOS PAC ID: 3971516758 Enrollment ID: I20060720000400 |
| Provider Name | Jessica B Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285827915 PECOS PAC ID: 9335237171 Enrollment ID: I20071113000309 |
| Provider Name | Vithya Balasubramaniam Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144529546 PECOS PAC ID: 6608016431 Enrollment ID: I20150720001399 |
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