| Churchville-chili Family Medicine, Llc | |
|
4201 Buffalo Rd Box 505 North Chili NY 14514-1256 | |
| (585) 594-5995 | |
| (585) 594-5425 |
| Full Name | Churchville-chili Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4201 Buffalo Rd, North Chili, New York |
| Authorized Official Name and Position | Henry Mikolaj Paszko (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5855945994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Churchville-chili Family Medicine, Llc Po Box 505 N. Chili NY 14514 Ph: (585) 594-5995 | Churchville-chili Family Medicine, Llc 4201 Buffalo Rd Box 505 North Chili NY 14514-1256 Ph: (585) 594-5995 |
| NPI Number | 1326231291 |
|---|---|
| Provider Enumeration Date | 08/23/2007 |
| Last Update Date | 11/04/2014 |
| Medicare PECOS PAC ID | 5294957874 |
|---|---|
| Medicare Enrollment ID | O20141114001670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326231291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 174814 (New York) | Primary |
| 261Q00000X | Clinic/center | 174814 (New York) | Secondary |
| Provider Name | Henry M Paszko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043260730 PECOS PAC ID: 7517941719 Enrollment ID: I20040615001655 |
| Provider Name | Nilsa M Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215929187 PECOS PAC ID: 6204809601 Enrollment ID: I20040814000017 |
| Provider Name | Rachel J Forberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497791271 PECOS PAC ID: 0446285019 Enrollment ID: I20051003000316 |
| Provider Name | Christine A Rodgers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871696401 PECOS PAC ID: 5193727717 Enrollment ID: I20070212000419 |
| Provider Name | Carol Coy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841304656 PECOS PAC ID: 6800971706 Enrollment ID: I20080317000053 |
| Provider Name | Jonathan W Hager |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114941846 PECOS PAC ID: 8921184904 Enrollment ID: I20101101000640 |
| Provider Name | Nancy A Ciavarri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346286614 PECOS PAC ID: 2668657883 Enrollment ID: I20110503000137 |
| Provider Name | Hui R Cai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982978110 PECOS PAC ID: 7315168176 Enrollment ID: I20141020000933 |
| Provider Name | Christopher Khamphoune |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457641557 PECOS PAC ID: 2668767559 Enrollment ID: I20160816002498 |
| Provider Name | Chanh C Huynh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447606215 PECOS PAC ID: 9638422538 Enrollment ID: I20190726002572 |
| Provider Name | Lara Camille Barco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528738689 PECOS PAC ID: 9739570920 Enrollment ID: I20211223000049 |
| Provider Name | Jacob W Phillips |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730317868 PECOS PAC ID: 7911370606 Enrollment ID: I20230228000803 |