| Alice Hyde Medical Center | |
|
133 Park St Malone NY 12953-1220 | |
| (518) 481-2210 | |
| (518) 481-2662 |
| Full Name | Alice Hyde Medical Center |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 133 Park St, Malone, New York |
| Authorized Official Name and Position | Chris Hickey (CFO) |
| Authorized Official Contact | 5184812847 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alice Hyde Medical Center 133 Park St Malone NY 12953-1220 Ph: (518) 481-2210 | Alice Hyde Medical Center 133 Park St Malone NY 12953-1220 Ph: (518) 481-2210 |
| NPI Number | 1114954682 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 02/17/2024 |
| Medicare PECOS PAC ID | 4082525837 |
|---|---|
| Medicare Enrollment ID | O20031126000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114954682 | NPI | - | NPPES |
| 00354114 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | 1624000H (New York) | Primary |
| Provider Name | Samuel Daniel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083622716 PECOS PAC ID: 5395658470 Enrollment ID: I20031106000322 |
| Provider Name | Helena Hozak Haase |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447245717 PECOS PAC ID: 8921909490 Enrollment ID: I20040116000901 |
| Provider Name | Gerald W Cahill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033292586 PECOS PAC ID: 6507752375 Enrollment ID: I20040227000126 |
| Provider Name | Jeffrey M Greenberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902003205 PECOS PAC ID: 5799677191 Enrollment ID: I20040329001548 |
| Provider Name | Lisa E Connery |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619973294 PECOS PAC ID: 6901895820 Enrollment ID: I20040506001709 |
| Provider Name | Myrna A Sanchez-latreille |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1134107600 PECOS PAC ID: 1850295841 Enrollment ID: I20040511001651 |
| Provider Name | Caroline Hamel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003881392 PECOS PAC ID: 1456334267 Enrollment ID: I20040611000908 |
| Provider Name | Jennifer J Kelly |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1104867779 PECOS PAC ID: 0042298952 Enrollment ID: I20040708000609 |
| Provider Name | Jan E Duus |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1114098589 PECOS PAC ID: 4284607797 Enrollment ID: I20040813000518 |
| Provider Name | Jeffrey Baruch Shoub |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194878793 PECOS PAC ID: 6305811274 Enrollment ID: I20040902000076 |
| Provider Name | Christopher S Palma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184637233 PECOS PAC ID: 3173599834 Enrollment ID: I20040903000941 |
| Provider Name | William R Latreille |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508885716 PECOS PAC ID: 4284696170 Enrollment ID: I20041102001106 |
| Provider Name | Sylvia Goodwin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700970308 PECOS PAC ID: 9931155892 Enrollment ID: I20050324000215 |
| Provider Name | Anjni G Bhagat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013019454 PECOS PAC ID: 5395731087 Enrollment ID: I20050504000062 |
| Provider Name | Vy B Rossi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881640951 PECOS PAC ID: 2961445986 Enrollment ID: I20050609000794 |
| Provider Name | Leonardo Dishman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1528176682 PECOS PAC ID: 3072557701 Enrollment ID: I20050614000844 |
| Provider Name | Daniel Burns |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508810821 PECOS PAC ID: 3870570302 Enrollment ID: I20050808000402 |
| Provider Name | Karen B Case |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831165679 PECOS PAC ID: 0941230908 Enrollment ID: I20050819000618 |
| Provider Name | Linda L Johnston |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1285690933 PECOS PAC ID: 6901836782 Enrollment ID: I20050822000567 |
| Provider Name | Robert Eberle |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962407205 PECOS PAC ID: 9436181823 Enrollment ID: I20050907000304 |
| Provider Name | Vladimir Medved |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1760572903 PECOS PAC ID: 0547228629 Enrollment ID: I20051207000736 |
| Provider Name | Steven C Goldstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780740860 PECOS PAC ID: 3971494360 Enrollment ID: I20051221000657 |
| Provider Name | Jacqueline Carrie Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396729851 PECOS PAC ID: 7911921929 Enrollment ID: I20060117001168 |
| Provider Name | James S Kenney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134186703 PECOS PAC ID: 2567476948 Enrollment ID: I20060208000741 |
| Provider Name | Wolodymyr I Bula |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497712541 PECOS PAC ID: 8921012303 Enrollment ID: I20060208000766 |
| Provider Name | Joel J Schnure |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1154334142 PECOS PAC ID: 4587673512 Enrollment ID: I20060419000276 |
| Provider Name | Brenda J Lepage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790799898 PECOS PAC ID: 4789681727 Enrollment ID: I20061103000350 |
| Provider Name | Mary R Mcgonagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528091436 PECOS PAC ID: 5890792873 Enrollment ID: I20061106000126 |
| Provider Name | Nidal Makhoul |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063409282 PECOS PAC ID: 4284548819 Enrollment ID: I20070129000214 |
| Provider Name | Howard M Black |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871500124 PECOS PAC ID: 3577666858 Enrollment ID: I20070306000540 |
| Provider Name | Stephanie Leffler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336179365 PECOS PAC ID: 9436254927 Enrollment ID: I20070411000244 |
| Provider Name | Pamela A Reinhardt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760588685 PECOS PAC ID: 3971600479 Enrollment ID: I20070517000478 |
| Provider Name | Wilhelmina M Sheridan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841367000 PECOS PAC ID: 7113028846 Enrollment ID: I20070725000610 |
| Provider Name | Dragos Macelaru |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316920960 PECOS PAC ID: 3678578176 Enrollment ID: I20070726000629 |
| Provider Name | Lori Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801987334 PECOS PAC ID: 8527154350 Enrollment ID: I20071010000051 |
| Provider Name | Austin D Sumner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609923259 PECOS PAC ID: 7113017310 Enrollment ID: I20071212000029 |
| Provider Name | Todd J Whitman |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1073585055 PECOS PAC ID: 0749217313 Enrollment ID: I20080618000394 |
| Provider Name | Robert A Gal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356396675 PECOS PAC ID: 8729150248 Enrollment ID: I20080627000454 |
| Provider Name | Christopher F Brandy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740371137 PECOS PAC ID: 8022183045 Enrollment ID: I20080826000338 |
| Provider Name | Seema A Lodha |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497945596 PECOS PAC ID: 4789760976 Enrollment ID: I20081028000340 |
| Provider Name | Lisa Mark |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699984989 PECOS PAC ID: 1850492539 Enrollment ID: I20081121000138 |
| Provider Name | Charles P Volk |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720187537 PECOS PAC ID: 2264336411 Enrollment ID: I20081226000218 |
| Provider Name | Alison J Guile |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417906629 PECOS PAC ID: 0749343549 Enrollment ID: I20090105000531 |
| Provider Name | Mia Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841311156 PECOS PAC ID: 2769545177 Enrollment ID: I20090112000439 |
| Provider Name | Claudia E Dumitrescu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588809602 PECOS PAC ID: 9133282445 Enrollment ID: I20090113000639 |
| Provider Name | Debra Piercey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437300654 PECOS PAC ID: 2567528128 Enrollment ID: I20090305000501 |
| Provider Name | Kenneth J Corse |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962433441 PECOS PAC ID: 1456327659 Enrollment ID: I20090401000002 |
| Provider Name | Eric A Gauthier |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1235283482 PECOS PAC ID: 0143307462 Enrollment ID: I20090608000196 |
| Provider Name | Eleanor Laclair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215186101 PECOS PAC ID: 2860545449 Enrollment ID: I20090729000532 |
| Provider Name | Deborah Lang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497722292 PECOS PAC ID: 5991784845 Enrollment ID: I20091007000218 |
| Provider Name | John A Lovier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386614436 PECOS PAC ID: 3476652892 Enrollment ID: I20091123000353 |
| Provider Name | Katherine E Bezio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730311663 PECOS PAC ID: 5496882748 Enrollment ID: I20100419000824 |
| Provider Name | Stuart M Hoffman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619927407 PECOS PAC ID: 8325935653 Enrollment ID: I20100728000974 |
| Provider Name | Julia I Ordonez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225165723 PECOS PAC ID: 7719001171 Enrollment ID: I20100908000223 |
| Provider Name | Teimuraz Apridonidze |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801064019 PECOS PAC ID: 5294850178 Enrollment ID: I20100915000835 |
| Provider Name | Joel M Wolkowicz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720091861 PECOS PAC ID: 6002882768 Enrollment ID: I20100920000303 |
| Provider Name | Katherine Walsh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689834442 PECOS PAC ID: 5991997553 Enrollment ID: I20101014000595 |
| Provider Name | Paul G El Azoury |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1225219884 PECOS PAC ID: 2163615626 Enrollment ID: I20101018000576 |
| Provider Name | Marina Medved |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1922040575 PECOS PAC ID: 3274591359 Enrollment ID: I20101025000930 |
| Provider Name | Cheryl Jasmin M Eustaquio |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437481983 PECOS PAC ID: 7911193289 Enrollment ID: I20101129000540 |
| Provider Name | William Pace |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588729966 PECOS PAC ID: 1951447911 Enrollment ID: I20101221000306 |
| Provider Name | Laura A Rizzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366456451 PECOS PAC ID: 7416940630 Enrollment ID: I20110103000475 |
| Provider Name | Thomas M Hughes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831121516 PECOS PAC ID: 1850375908 Enrollment ID: I20110119000418 |
| Provider Name | Eugene F Cassone |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902874902 PECOS PAC ID: 5991708208 Enrollment ID: I20110221000311 |
| Provider Name | John W Homer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841268836 PECOS PAC ID: 8224089719 Enrollment ID: I20110221000377 |
| Provider Name | Albert M Imobersteg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518161496 PECOS PAC ID: 1759477144 Enrollment ID: I20110405000268 |
| Provider Name | Rayford Petroski |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245297001 PECOS PAC ID: 2163522418 Enrollment ID: I20110518000000 |
| Provider Name | Laura M Schned |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1801944509 PECOS PAC ID: 6406032705 Enrollment ID: I20110523000312 |
| Provider Name | Rajiv Pant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154591931 PECOS PAC ID: 6608944103 Enrollment ID: I20110721000821 |
| Provider Name | Andrei Cepoi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043492127 PECOS PAC ID: 2163575564 Enrollment ID: I20110727000576 |
| Provider Name | Kent N Hall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851395354 PECOS PAC ID: 0446224901 Enrollment ID: I20110922000165 |
| Provider Name | Wendy L Frank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699087171 PECOS PAC ID: 7618149915 Enrollment ID: I20111011000013 |
| Provider Name | Julio A Lemos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689736720 PECOS PAC ID: 1254525835 Enrollment ID: I20120308000281 |
| Provider Name | Anne E Mcilhenny |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922214329 PECOS PAC ID: 1456512417 Enrollment ID: I20120418000506 |
| Provider Name | Alfred M Loka |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1427257500 PECOS PAC ID: 9335327683 Enrollment ID: I20120705000398 |
| Provider Name | Marzouq A Qubti |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1255429189 PECOS PAC ID: 0749371664 Enrollment ID: I20120712000071 |
| Provider Name | Christopher M Brennan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982749644 PECOS PAC ID: 5799963674 Enrollment ID: I20121002000437 |
| Provider Name | Vladimir Breslau |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063658797 PECOS PAC ID: 8729135363 Enrollment ID: I20130220000109 |
| Provider Name | David R Wagner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811129547 PECOS PAC ID: 5193969723 Enrollment ID: I20130920000095 |
| Provider Name | Kathryn O Giroux |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942460084 PECOS PAC ID: 1850525809 Enrollment ID: I20131008000161 |
| Provider Name | Elena Boland |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1063536886 PECOS PAC ID: 0941434435 Enrollment ID: I20131016002034 |
| Provider Name | Pierre Mechali |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528357274 PECOS PAC ID: 4688844525 Enrollment ID: I20131018000336 |
| Provider Name | Derek J Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285074054 PECOS PAC ID: 4183851199 Enrollment ID: I20131219001442 |
| Provider Name | Jessica K Veltkamp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740404615 PECOS PAC ID: 1052436953 Enrollment ID: I20140305000049 |
| Provider Name | Jujhar K Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013241967 PECOS PAC ID: 3274764121 Enrollment ID: I20140319000048 |
| Provider Name | Kathleen Lauzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427020320 PECOS PAC ID: 4587897202 Enrollment ID: I20140505001469 |
| Provider Name | Peter Rattner |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1710203765 PECOS PAC ID: 4486887007 Enrollment ID: I20140507000201 |
| Provider Name | Thomas J Giannaccini |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861814238 PECOS PAC ID: 1052535382 Enrollment ID: I20140606001309 |
| Provider Name | Amanda L Henderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174508907 PECOS PAC ID: 6800836883 Enrollment ID: I20140812002519 |
| Provider Name | Pierre Znojkiewicz |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1851435275 PECOS PAC ID: 9234355074 Enrollment ID: I20140814000237 |
| Provider Name | Dragos Banu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558659367 PECOS PAC ID: 6709004682 Enrollment ID: I20140908000667 |
| Provider Name | Molly Elizabeth Mentzer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114125903 PECOS PAC ID: 7517059033 Enrollment ID: I20140929000691 |
| Provider Name | Rebecca R Snickles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225445372 PECOS PAC ID: 1153643051 Enrollment ID: I20141204000026 |
| Provider Name | Manal El Daouk |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639484736 PECOS PAC ID: 3173847118 Enrollment ID: I20150121001539 |
| Provider Name | Cecilia Bacerdo Geralde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699979062 PECOS PAC ID: 7113088956 Enrollment ID: I20150123000541 |
| Provider Name | Matthew P Gilbert |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1073634531 PECOS PAC ID: 9234285487 Enrollment ID: I20150323001508 |
| Provider Name | Jeongjin Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891188033 PECOS PAC ID: 3274852249 Enrollment ID: I20150427000055 |
| Provider Name | Russell Meyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124260138 PECOS PAC ID: 4082680400 Enrollment ID: I20150828001895 |
| Provider Name | Hanna B Slim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417130410 PECOS PAC ID: 0749332229 Enrollment ID: I20150914001040 |
| Provider Name | Prabhjot Manes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922495100 PECOS PAC ID: 1052629383 Enrollment ID: I20151006000911 |
| Provider Name | Zakir Hussain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871640599 PECOS PAC ID: 9537262324 Enrollment ID: I20151103000053 |
| Provider Name | Kirstyn Indgjer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740669787 PECOS PAC ID: 3971813403 Enrollment ID: I20151112000782 |
| Provider Name | Christopher A Deangelis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366720062 PECOS PAC ID: 0244531507 Enrollment ID: I20151211000028 |
| Provider Name | Joshua A Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598148967 PECOS PAC ID: 5890097877 Enrollment ID: I20160107002082 |
| Provider Name | Virginia F Paik |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376900738 PECOS PAC ID: 3375848906 Enrollment ID: I20160219000926 |
| Provider Name | Jessica M Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194107789 PECOS PAC ID: 7012212145 Enrollment ID: I20160226000993 |
| Provider Name | Richard Zubarik |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396818100 PECOS PAC ID: 0941259220 Enrollment ID: I20160412001660 |
| Provider Name | Steven E Deso |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194033464 PECOS PAC ID: 0042502544 Enrollment ID: I20160701000294 |
| Provider Name | Tiffany Bombard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417290610 PECOS PAC ID: 6800188566 Enrollment ID: I20160718000385 |
| Provider Name | Joseph E Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508946443 PECOS PAC ID: 2466407549 Enrollment ID: I20160825002625 |
| Provider Name | Sarah Wade W Boatwright |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073856555 PECOS PAC ID: 7113213406 Enrollment ID: I20160913001761 |
| Provider Name | David M Cartee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538515788 PECOS PAC ID: 0547557035 Enrollment ID: I20160927002510 |
| Provider Name | Brianne L Jeror |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699127795 PECOS PAC ID: 1355639188 Enrollment ID: I20161011003232 |
| Provider Name | Daniel H Laury |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508846932 PECOS PAC ID: 9537329057 Enrollment ID: I20161012000087 |
| Provider Name | Aderonke O Adeniyi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1407090095 PECOS PAC ID: 8820376502 Enrollment ID: I20161101000155 |
| Provider Name | Alison L Grabowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649621905 PECOS PAC ID: 2769762293 Enrollment ID: I20161129001916 |
| Provider Name | Franklin J. Bertuch |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477586006 PECOS PAC ID: 8325930472 Enrollment ID: I20170112000076 |
| Provider Name | Terri Redmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699117630 PECOS PAC ID: 8527202035 Enrollment ID: I20170124000692 |
| Provider Name | Stephen L Kessler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922009174 PECOS PAC ID: 2365579166 Enrollment ID: I20170220000194 |
| Provider Name | Kristina Marie Colwell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1508315524 PECOS PAC ID: 8527342682 Enrollment ID: I20170309000832 |
| Provider Name | Irwin M Reich |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578551073 PECOS PAC ID: 8325023039 Enrollment ID: I20170323000977 |
| Provider Name | Mohamed M Zawahir |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619915709 PECOS PAC ID: 7911283650 Enrollment ID: I20170413000370 |
| Provider Name | Grant Shannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881139863 PECOS PAC ID: 4486930641 Enrollment ID: I20170425000045 |
| Provider Name | Christopher M Viscomi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235173204 PECOS PAC ID: 8820007693 Enrollment ID: I20170612000421 |
| Provider Name | Yohaimi E Cosme Ayala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811254782 PECOS PAC ID: 1456621317 Enrollment ID: I20170725004110 |
| Provider Name | Michael Savarese |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174885776 PECOS PAC ID: 8325320328 Enrollment ID: I20170809002412 |
| Provider Name | Rachael A Hite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417482027 PECOS PAC ID: 8820363880 Enrollment ID: I20171002002877 |
| Provider Name | Birinder S Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235485061 PECOS PAC ID: 0345567525 Enrollment ID: I20171101002768 |
| Provider Name | Zachary A Kanouse |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235426024 PECOS PAC ID: 7012210313 Enrollment ID: I20171117001099 |
| Provider Name | Jose M Acostamadiedo |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1013910256 PECOS PAC ID: 5890719371 Enrollment ID: I20171121000654 |
| Provider Name | Stacy A Mckenzie-harvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487170882 PECOS PAC ID: 3375800675 Enrollment ID: I20171121002260 |
| Provider Name | Steven Shamosh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265639116 PECOS PAC ID: 5496036030 Enrollment ID: I20171121002490 |
| Provider Name | Nancy Denis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811408826 PECOS PAC ID: 5597028878 Enrollment ID: I20180419001371 |
| Provider Name | David M Cowles |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497016232 PECOS PAC ID: 0840447249 Enrollment ID: I20180430002043 |
| Provider Name | Rodolfo L Dy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639143910 PECOS PAC ID: 9638249568 Enrollment ID: I20180720001006 |
| Provider Name | Dawn M Sharlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922294347 PECOS PAC ID: 5193072940 Enrollment ID: I20180725000079 |
| Provider Name | Hector Manuel Cabeza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790942688 PECOS PAC ID: 1456544774 Enrollment ID: I20180803000428 |
| Provider Name | Megan E Gagner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760987572 PECOS PAC ID: 5698024040 Enrollment ID: I20180820000716 |
| Provider Name | Donielle F Sliwa |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1376809277 PECOS PAC ID: 9032343140 Enrollment ID: I20180904000834 |
| Provider Name | Lettita Z Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578948311 PECOS PAC ID: 1254681521 Enrollment ID: I20180906002960 |
| Provider Name | Laurent Gilloteaux |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265925630 PECOS PAC ID: 9830440759 Enrollment ID: I20180914002395 |
| Provider Name | Lars M Galldin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063640902 PECOS PAC ID: 3274775945 Enrollment ID: I20180925001603 |
| Provider Name | Walter L Walters |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548215601 PECOS PAC ID: 1951576487 Enrollment ID: I20181228001794 |
| Provider Name | Darlean L James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245717115 PECOS PAC ID: 6103164488 Enrollment ID: I20190212001012 |
| Provider Name | Nicole A Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730661000 PECOS PAC ID: 5890037139 Enrollment ID: I20190507000612 |
| Provider Name | Nicolas M Karam |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1760527113 PECOS PAC ID: 4789784992 Enrollment ID: I20190523000604 |
| Provider Name | Vincent Persaud |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861757064 PECOS PAC ID: 6800129123 Enrollment ID: I20190531000431 |
| Provider Name | Brandon Sur |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518227180 PECOS PAC ID: 3870888514 Enrollment ID: I20190603002305 |
| Provider Name | John J Campbell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841619319 PECOS PAC ID: 7113145251 Enrollment ID: I20190726000332 |
| Provider Name | Aline Bayard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972961068 PECOS PAC ID: 2466756291 Enrollment ID: I20190829001304 |
| Provider Name | Kathy Lynn Wirz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417514712 PECOS PAC ID: 4385077361 Enrollment ID: I20191205000142 |
| Provider Name | Jennifer Lynn Shull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780235622 PECOS PAC ID: 3971938457 Enrollment ID: I20200109001787 |
| Provider Name | Qi Si Si Xue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811537608 PECOS PAC ID: 4082042775 Enrollment ID: I20200311001211 |
| Provider Name | Sergio Apuzzo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992261887 PECOS PAC ID: 4486981958 Enrollment ID: I20200803000929 |
| Provider Name | Ashley Weisman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801158324 PECOS PAC ID: 0042464570 Enrollment ID: I20200807001137 |
| Provider Name | Arman Khorasani-zadeh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548542756 PECOS PAC ID: 1355768482 Enrollment ID: I20200903000411 |
| Provider Name | Chris Ann Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760786073 PECOS PAC ID: 8729407614 Enrollment ID: I20200925001344 |
| Provider Name | Arlene Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982227575 PECOS PAC ID: 0840619755 Enrollment ID: I20200925002065 |
| Provider Name | Michal Nowak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710397567 PECOS PAC ID: 8123354040 Enrollment ID: I20201012002327 |
| Provider Name | Kayla L Rumack |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841744026 PECOS PAC ID: 2466791041 Enrollment ID: I20201028003112 |
| Provider Name | Eric Wong |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962821058 PECOS PAC ID: 0446521066 Enrollment ID: I20201116000042 |
| Provider Name | David D Christensen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700204922 PECOS PAC ID: 5991006751 Enrollment ID: I20201201000106 |
| Provider Name | Renu Yadav |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669620985 PECOS PAC ID: 3971915240 Enrollment ID: I20201209003079 |
| Provider Name | Ellen G Apple |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1548864150 PECOS PAC ID: 2961814959 Enrollment ID: I20201216001070 |
| Provider Name | Kavitha Sri Vemuri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649658261 PECOS PAC ID: 0840539235 Enrollment ID: I20210106000086 |
| Provider Name | Gary Starr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598898157 PECOS PAC ID: 4880790096 Enrollment ID: I20210106000209 |
| Provider Name | Teddi I Bachawaty |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154304228 PECOS PAC ID: 7416976360 Enrollment ID: I20210318000541 |
| Provider Name | Michael G D'urso |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790281988 PECOS PAC ID: 6204237142 Enrollment ID: I20210629002077 |
| Provider Name | Pearl Hersh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255836862 PECOS PAC ID: 1153676424 Enrollment ID: I20210729001951 |
| Provider Name | Jennifer Lynn Stedman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225490097 PECOS PAC ID: 9032513742 Enrollment ID: I20210803001389 |
| Provider Name | Ruxing Xing |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881182681 PECOS PAC ID: 6406250489 Enrollment ID: I20210812003209 |
| Provider Name | Kyle Barbour |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346730736 PECOS PAC ID: 3678826591 Enrollment ID: I20210910001646 |
| Provider Name | Rebecca Parad |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942731104 PECOS PAC ID: 6901177971 Enrollment ID: I20211005001655 |
| Provider Name | Justin Mcmaster |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851748560 PECOS PAC ID: 4284971581 Enrollment ID: I20211011000798 |
| Provider Name | James East |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952763575 PECOS PAC ID: 2961797543 Enrollment ID: I20211117001052 |
| Provider Name | Joel J Cherian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568958411 PECOS PAC ID: 5991195802 Enrollment ID: I20211208003344 |
| Provider Name | Christopher Morris |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528089166 PECOS PAC ID: 2961419122 Enrollment ID: I20220106000496 |
| Provider Name | Joshua Marlow |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1346602257 PECOS PAC ID: 1759612914 Enrollment ID: I20220301000161 |
| Provider Name | Sylvia Diaz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1083880009 PECOS PAC ID: 9537303813 Enrollment ID: I20220427001075 |
| Provider Name | Brooke Stark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992459028 PECOS PAC ID: 0345637708 Enrollment ID: I20220504000043 |
| Provider Name | Geoffrey Michael Scriver |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1245452192 PECOS PAC ID: 9638325699 Enrollment ID: I20220504000271 |
| Provider Name | Moataz Behairy |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1801215868 PECOS PAC ID: 3375888142 Enrollment ID: I20220531002525 |
| Provider Name | Bruce J Grattan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265096911 PECOS PAC ID: 5698173433 Enrollment ID: I20220802000736 |
| Provider Name | Louai Naddaf |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154982544 PECOS PAC ID: 7517391188 Enrollment ID: I20220819002156 |
| Provider Name | John Haines |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1669793121 PECOS PAC ID: 4082987896 Enrollment ID: I20220923001118 |
| Provider Name | Bryan C Patraw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851939466 PECOS PAC ID: 7012325707 Enrollment ID: I20221003001889 |
| Provider Name | James B Seipp |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255861647 PECOS PAC ID: 4587086194 Enrollment ID: I20221109000739 |
| Provider Name | Julia Marsala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851895338 PECOS PAC ID: 5092079624 Enrollment ID: I20221114002127 |
| Provider Name | Nichole Bedard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386378412 PECOS PAC ID: 4587032958 Enrollment ID: I20221116002825 |
| Provider Name | Stanley Yang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902458391 PECOS PAC ID: 1153799937 Enrollment ID: I20221129001811 |
| Provider Name | Marc A Cassone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881057149 PECOS PAC ID: 0244526770 Enrollment ID: I20221209002675 |
| Provider Name | Maysaa El Zoghbi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043528250 PECOS PAC ID: 3577820984 Enrollment ID: I20221212002248 |
| Provider Name | Robin Spurlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497101802 PECOS PAC ID: 6103117221 Enrollment ID: I20230217001639 |
| Provider Name | Terrence O'connor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063851673 PECOS PAC ID: 1557630613 Enrollment ID: I20230405001884 |
| Provider Name | Misty Bendall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376717389 PECOS PAC ID: 2769481704 Enrollment ID: I20230421000793 |
| Provider Name | Nektarios Konstantinopoulos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528696853 PECOS PAC ID: 7012338452 Enrollment ID: I20230607002039 |
| Provider Name | Gabriel Crevier-sorbo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154946978 PECOS PAC ID: 2264892017 Enrollment ID: I20230712002666 |
| Provider Name | Heather Lottie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346930500 PECOS PAC ID: 7911368329 Enrollment ID: I20230802000458 |
| Provider Name | Wendell A Bliss |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356848857 PECOS PAC ID: 4688095920 Enrollment ID: I20230821002059 |
| Provider Name | Madison L Daly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972063493 PECOS PAC ID: 7315270790 Enrollment ID: I20230914002261 |
| Provider Name | John Henry Priester |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821626748 PECOS PAC ID: 7214358753 Enrollment ID: I20230914002421 |
| Provider Name | Beth Verdone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679100846 PECOS PAC ID: 7719331362 Enrollment ID: I20230929002683 |
| Provider Name | Shanelle Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083499438 PECOS PAC ID: 2062868599 Enrollment ID: I20231019002300 |
| Provider Name | Katherine Patrick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144781972 PECOS PAC ID: 3274867056 Enrollment ID: I20231020001950 |
| Provider Name | Michael Waterhouse |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1629539879 PECOS PAC ID: 4587010871 Enrollment ID: I20231023002174 |
| Provider Name | Makenzie Ann Winslow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144947904 PECOS PAC ID: 2668820622 Enrollment ID: I20231130003604 |
| Provider Name | Michael P Bazylewicz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760707236 PECOS PAC ID: 5395065924 Enrollment ID: I20231204001299 |
| Provider Name | Christopher Kanner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689085748 PECOS PAC ID: 3375844525 Enrollment ID: I20231206002596 |
| Provider Name | Robert D'agostino |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336160159 PECOS PAC ID: 4385652130 Enrollment ID: I20240108003668 |
| Provider Name | Rheta Recore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700209871 PECOS PAC ID: 5799137634 Enrollment ID: I20240117000665 |
| Provider Name | Iustin Stefan Moga |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568240026 PECOS PAC ID: 3779926662 Enrollment ID: I20240207003567 |
| Provider Name | Timothy Higgins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174558175 PECOS PAC ID: 5092754499 Enrollment ID: I20240319000342 |
| Provider Name | Adam Ulano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275762551 PECOS PAC ID: 8325263544 Enrollment ID: I20240319000414 |
| Provider Name | Benjamin Lange |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770725467 PECOS PAC ID: 2365663911 Enrollment ID: I20240402002587 |
| Provider Name | William Parkinson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760914584 PECOS PAC ID: 8921375551 Enrollment ID: I20240404001328 |
| Provider Name | Saeedeh Mirbagheri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376938837 PECOS PAC ID: 7618215161 Enrollment ID: I20240405002413 |
| Provider Name | Benjamin Sawatzky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235549247 PECOS PAC ID: 0345559357 Enrollment ID: I20240411002143 |
| Provider Name | Janusz Kikut |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053338889 PECOS PAC ID: 1658318712 Enrollment ID: I20240411002302 |
| Provider Name | Cynthia M Chan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851653513 PECOS PAC ID: 4284976705 Enrollment ID: I20240412003241 |
| Provider Name | Carl W Cobb |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083650733 PECOS PAC ID: 0840280236 Enrollment ID: I20240416000131 |
| Provider Name | Anjuli R Bagley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538422084 PECOS PAC ID: 3173824927 Enrollment ID: I20240416003044 |
| Provider Name | Dmitriy G Akselrod |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629241336 PECOS PAC ID: 4385805696 Enrollment ID: I20240417002388 |
| Provider Name | Charles Pappas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932286523 PECOS PAC ID: 8729002514 Enrollment ID: I20240508000196 |
| Provider Name | Andrea Hildebrand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366469181 PECOS PAC ID: 4486755287 Enrollment ID: I20240514002198 |
| Provider Name | Norman Sturtevant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164449963 PECOS PAC ID: 6204840697 Enrollment ID: I20240515004170 |
| Provider Name | Pedro Staziaki |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912358318 PECOS PAC ID: 3577836410 Enrollment ID: I20240517002118 |
Hudson Headwaters Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16 3rd St Ste A, Malone, NY 12953 Phone: 518-824-2562 Fax: 833-941-5091 | |
Main Street Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Clay St, Malone, NY 12953 Phone: 518-483-0705 Fax: 518-483-1375 | |
Malone Internal Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16 3rd St, Malone, NY 12953 Phone: 518-483-4400 Fax: 518-483-1333 | |
Jonathan Lowell, M.d. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Park St, Malone, NY 12953 Phone: 518-483-1120 | |
Rajiv S Shah Physician P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Clay St, Malone, NY 12953 Phone: 518-483-0705 Fax: 518-483-1375 | |
North Country Health Care, Medical Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 4th St, Malone, NY 12953 Phone: 518-481-6044 Fax: 518-481-6043 |