Danielle Provoncha, CRNA | |
365 Montauk Ave, New London, CT 06320-4700 | |
(860) 442-0711 | |
(781) 407-0998 |
Full Name | Danielle Provoncha |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 10 Years |
Location | 365 Montauk Ave, New London, Connecticut |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619373248 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 6012 (Connecticut) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Manchester Memorial Hospital | Manchester, CT | Hospital |
Windham Community Memorial Hospital | Willimantic, CT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Integrated Anesthesia Associates Llc | 1759281165 | 391 |
Anesthesia Associates Of Willimantic, Pc | 2163506353 | 48 |
Charter Anesthesiology Llc | 2163763830 | 37 |
Entity Name | Integrated Anesthesia Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881636397 PECOS PAC ID: 1759281165 Enrollment ID: O20040112000163 |
Entity Name | Anesthesia Associates Of Willimantic, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306905799 PECOS PAC ID: 2163506353 Enrollment ID: O20080227000090 |
Entity Name | Charter Anesthesiology Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730674532 PECOS PAC ID: 2163763830 Enrollment ID: O20190520001013 |
Mailing Address | Practice Location Address |
---|---|
Danielle Provoncha, CRNA 690 Canton St, Suite 325, Westwood, MA 02090-2321 Ph: (781) 407-7713 | Danielle Provoncha, CRNA 365 Montauk Ave, New London, CT 06320-4700 Ph: (860) 442-0711 |
Judith Ann Mcgannon, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 365 Montauk, Lawrence And Memorial Hospital, New London, CT 06320 Phone: 860-442-0711 | |
Tara M Huta, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-442-0711 Fax: 781-407-0998 | |
Sharon B Gallipeau, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-442-0711 | |
Thomas Scott Long, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-442-0711 | |
Jolene Marie Oliver, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 206-384-6204 | |
Stefanie Guarino, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-442-0711 Fax: 781-407-0998 | |
Ekelechi Nwanju, CRNA, DNP Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 973-970-8044 |