| Completecare Health Network | |
|
30 North Pearl Street Bridgeton NJ 08302-1902 | |
| (856) 451-4700 | |
| (856) 451-0029 |
| Full Name | Completecare Health Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 30 North Pearl Street, Bridgeton, New Jersey |
| Authorized Official Name and Position | James C Edwards (CEO/PRESIDENT) |
| Authorized Official Contact | 8564514700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Completecare Health Network 14 N Pearl St Bridgeton NJ 08302-1902 Ph: () - | Completecare Health Network 30 North Pearl Street Bridgeton NJ 08302-1902 Ph: (856) 451-4700 |
| NPI Number | 1700816816 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 03/23/2022 |
| Medicare PECOS PAC ID | 9335040419 |
|---|---|
| Medicare Enrollment ID | O20040402000981 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700816816 | NPI | - | NPPES |
| 0044806 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Rajesh P Farmer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104845338 PECOS PAC ID: 2860396264 Enrollment ID: I20031126000030 |
| Provider Name | Morris Antebi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578532404 PECOS PAC ID: 9032013032 Enrollment ID: I20031208000770 |
| Provider Name | Douglas J Hanes |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225138910 PECOS PAC ID: 2860398583 Enrollment ID: I20031211000766 |
| Provider Name | Mangesh M Mungekar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144306069 PECOS PAC ID: 8820994544 Enrollment ID: I20031211000779 |
| Provider Name | Stephen Richar Noone |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1245250612 PECOS PAC ID: 1658367917 Enrollment ID: I20040422000276 |
| Provider Name | David R Gerber |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861580219 PECOS PAC ID: 8224025226 Enrollment ID: I20040430000166 |
| Provider Name | Luciano J Bispo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144206384 PECOS PAC ID: 3870580756 Enrollment ID: I20040430000840 |
| Provider Name | Rula A Al-hilli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154320315 PECOS PAC ID: 4082697297 Enrollment ID: I20040609000993 |
| Provider Name | Kristen Rainear |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689662165 PECOS PAC ID: 3072597970 Enrollment ID: I20040617000532 |
| Provider Name | Christopher Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417979618 PECOS PAC ID: 2264402791 Enrollment ID: I20040730000358 |
| Provider Name | Robin A Meadows |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881618130 PECOS PAC ID: 9133182322 Enrollment ID: I20041109000447 |
| Provider Name | Inciya Rangwalla-malickel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952491250 PECOS PAC ID: 9830153873 Enrollment ID: I20041118000557 |
| Provider Name | Steven F Dorfman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1922125392 PECOS PAC ID: 8426008889 Enrollment ID: I20050125000109 |
| Provider Name | Nicholas J Giorgianni |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1114953676 PECOS PAC ID: 4789637463 Enrollment ID: I20050222000685 |
| Provider Name | Mark A Thomas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043391618 PECOS PAC ID: 2961392493 Enrollment ID: I20050302000598 |
| Provider Name | Christine M Rennie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952070369 PECOS PAC ID: 9830138023 Enrollment ID: I20050427000697 |
| Provider Name | Jeanette Jimenez Silva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982798914 PECOS PAC ID: 3476442625 Enrollment ID: I20050622000038 |
| Provider Name | Christine S Kotulski |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1780603902 PECOS PAC ID: 4385680586 Enrollment ID: I20050628000922 |
| Provider Name | Rachel L Grencavich |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1023053378 PECOS PAC ID: 9234169962 Enrollment ID: I20050812000727 |
| Provider Name | Frank M D'orio |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154323442 PECOS PAC ID: 8022036847 Enrollment ID: I20051114001033 |
| Provider Name | Alan Greenberg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326092180 PECOS PAC ID: 0345263851 Enrollment ID: I20060111000397 |
| Provider Name | Hasmukhbhai D Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891756789 PECOS PAC ID: 4486678513 Enrollment ID: I20060117000411 |
| Provider Name | Aliya W Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366473654 PECOS PAC ID: 5395769673 Enrollment ID: I20060125000822 |
| Provider Name | Prabha J Nair |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174559207 PECOS PAC ID: 3072527084 Enrollment ID: I20060201000455 |
| Provider Name | Joseph L Milio |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821072745 PECOS PAC ID: 7214942770 Enrollment ID: I20060221000009 |
| Provider Name | Richard A Michner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376527291 PECOS PAC ID: 2769497221 Enrollment ID: I20060221000016 |
| Provider Name | Jazmine Harris |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881693844 PECOS PAC ID: 3173531647 Enrollment ID: I20060324000030 |
| Provider Name | Shawna I Reigel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619900586 PECOS PAC ID: 5890708317 Enrollment ID: I20060728000006 |
| Provider Name | Christina V Orate Dimapilis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508831330 PECOS PAC ID: 0941208565 Enrollment ID: I20061115000083 |
| Provider Name | Kelly A Chirico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881746774 PECOS PAC ID: 0345341327 Enrollment ID: I20070720000138 |
| Provider Name | Mary A Herron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366479891 PECOS PAC ID: 8729179932 Enrollment ID: I20070802000112 |
| Provider Name | Diane M Burt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043229883 PECOS PAC ID: 5395838718 Enrollment ID: I20070830000463 |
| Provider Name | William M Mclean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558368357 PECOS PAC ID: 0840383063 Enrollment ID: I20070905000011 |
| Provider Name | Elis De Priori |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1598712861 PECOS PAC ID: 0749373660 Enrollment ID: I20070910000396 |
| Provider Name | Uma R Panganamamula |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558326306 PECOS PAC ID: 5890769756 Enrollment ID: I20071003000107 |
| Provider Name | Gayatri Borra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972676112 PECOS PAC ID: 5496842015 Enrollment ID: I20071030000130 |
| Provider Name | Elham M Ismail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225057276 PECOS PAC ID: 8820042351 Enrollment ID: I20080305000429 |
| Provider Name | Gbolagade O Babalola |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952301681 PECOS PAC ID: 2062443633 Enrollment ID: I20080421000278 |
| Provider Name | Sylvester Hamilton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265415798 PECOS PAC ID: 9638070485 Enrollment ID: I20080421000354 |
| Provider Name | Barbara J Roehl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962578807 PECOS PAC ID: 5890873509 Enrollment ID: I20080422000319 |
| Provider Name | Irina Levin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477749182 PECOS PAC ID: 0244318715 Enrollment ID: I20080424000006 |
| Provider Name | Gina Glass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518940394 PECOS PAC ID: 3678547676 Enrollment ID: I20080424000439 |
| Provider Name | Christopher B Simkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992977854 PECOS PAC ID: 0042389504 Enrollment ID: I20080523000264 |
| Provider Name | Shailja Roy |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1508898594 PECOS PAC ID: 0749287951 Enrollment ID: I20080716000664 |
| Provider Name | Sandra M Gould Mulligan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174545420 PECOS PAC ID: 2365517505 Enrollment ID: I20080821000663 |
| Provider Name | Karen A Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932369865 PECOS PAC ID: 3678649639 Enrollment ID: I20080828000036 |
| Provider Name | Margaret E Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427248434 PECOS PAC ID: 4587730692 Enrollment ID: I20080912000540 |
| Provider Name | Angela M Pizzo-kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437284957 PECOS PAC ID: 4486713286 Enrollment ID: I20081108000006 |
| Provider Name | Sussannah S Walsh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548411895 PECOS PAC ID: 9638232861 Enrollment ID: I20090114000015 |
| Provider Name | Paul P Mcmackin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720249428 PECOS PAC ID: 7113083593 Enrollment ID: I20090310000404 |
| Provider Name | Alka Rajesh Farmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821207143 PECOS PAC ID: 4082764618 Enrollment ID: I20090602000583 |
| Provider Name | Jennifer A Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629203948 PECOS PAC ID: 4789720301 Enrollment ID: I20091012000278 |
| Provider Name | Jacob F Cogen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295994853 PECOS PAC ID: 6103966163 Enrollment ID: I20091223000034 |
| Provider Name | Darlene P Deamer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184950321 PECOS PAC ID: 3870633613 Enrollment ID: I20091229000563 |
| Provider Name | Cathy L Geria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932151610 PECOS PAC ID: 3971680018 Enrollment ID: I20091231000022 |
| Provider Name | Dan Dragomir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427071091 PECOS PAC ID: 8628075041 Enrollment ID: I20100201000568 |
| Provider Name | Holly Huber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346347986 PECOS PAC ID: 1557406675 Enrollment ID: I20100301000551 |
| Provider Name | Sharon W Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437487907 PECOS PAC ID: 4981739810 Enrollment ID: I20100317000962 |
| Provider Name | Laurie A Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003041427 PECOS PAC ID: 6103953765 Enrollment ID: I20100430000016 |
| Provider Name | Amy J Siegel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992736680 PECOS PAC ID: 5092843581 Enrollment ID: I20100504000120 |
| Provider Name | Scott Warren |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396782397 PECOS PAC ID: 9537231402 Enrollment ID: I20100708000067 |
| Provider Name | Jean C Pilet |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1750442125 PECOS PAC ID: 9234263211 Enrollment ID: I20100812000362 |
| Provider Name | Jean-sebastien K Rachoin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174796213 PECOS PAC ID: 6608991401 Enrollment ID: I20100916001266 |
| Provider Name | Fred Michael Nichols |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982677233 PECOS PAC ID: 9830294156 Enrollment ID: I20101209001286 |
| Provider Name | Anna Alberici |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1184650848 PECOS PAC ID: 8022206861 Enrollment ID: I20101221000840 |
| Provider Name | Jean Haspel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932146750 PECOS PAC ID: 4789863622 Enrollment ID: I20110125000722 |
| Provider Name | Justyna Obara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174768048 PECOS PAC ID: 8022297720 Enrollment ID: I20110127000316 |
| Provider Name | Benjamin P Negin |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1366477697 PECOS PAC ID: 3375648140 Enrollment ID: I20110203000975 |
| Provider Name | Fritzi Tanner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326140013 PECOS PAC ID: 7113108614 Enrollment ID: I20110216000630 |
| Provider Name | Vonetta T Sylvestre |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740411362 PECOS PAC ID: 8123169919 Enrollment ID: I20111024000346 |
| Provider Name | Kush Sachdeva |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750372686 PECOS PAC ID: 8426061482 Enrollment ID: I20120206000757 |
| Provider Name | Margaret Moloney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104197029 PECOS PAC ID: 0446412670 Enrollment ID: I20120503000419 |
| Provider Name | Charlotte A Dimarco Morrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275809998 PECOS PAC ID: 0244493690 Enrollment ID: I20120522000868 |
| Provider Name | Veronica Gonzalez-rivera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578722740 PECOS PAC ID: 1658534771 Enrollment ID: I20120529000379 |
| Provider Name | Mylene S Go |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1992964696 PECOS PAC ID: 0547333445 Enrollment ID: I20120828000073 |
| Provider Name | Melissa B Mangold |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699939561 PECOS PAC ID: 7618155839 Enrollment ID: I20121008000323 |
| Provider Name | Catherine T Maturo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326068099 PECOS PAC ID: 5698810612 Enrollment ID: I20121022000008 |
| Provider Name | Olga E Jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396947792 PECOS PAC ID: 8426202599 Enrollment ID: I20130128000045 |
| Provider Name | Deirdre Conroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710286042 PECOS PAC ID: 7012162381 Enrollment ID: I20130313000202 |
| Provider Name | Marlin E Gross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578838710 PECOS PAC ID: 3577708304 Enrollment ID: I20130328000086 |
| Provider Name | Rosalia E Hyatt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215019096 PECOS PAC ID: 0345290680 Enrollment ID: I20130628000622 |
| Provider Name | Sameer Poddar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740591247 PECOS PAC ID: 8628212982 Enrollment ID: I20130926000649 |
| Provider Name | Cindy J Hogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538410527 PECOS PAC ID: 7810132008 Enrollment ID: I20131014000308 |
| Provider Name | Stacy L Williams-hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821423013 PECOS PAC ID: 1850528894 Enrollment ID: I20131218000888 |
| Provider Name | Lin Zheng |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598095747 PECOS PAC ID: 1759573439 Enrollment ID: I20140113001055 |
| Provider Name | Azizeh J Salloum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376857177 PECOS PAC ID: 4688802853 Enrollment ID: I20140115000515 |
| Provider Name | Vijay K Sandilya |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1801118906 PECOS PAC ID: 4587788112 Enrollment ID: I20140219001266 |
| Provider Name | Scott C Hollander |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609030758 PECOS PAC ID: 8224192323 Enrollment ID: I20140222000282 |
| Provider Name | Denise L Masilotti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790057727 PECOS PAC ID: 7416187281 Enrollment ID: I20140224001606 |
| Provider Name | Catherine M Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225463474 PECOS PAC ID: 5597995712 Enrollment ID: I20140307000409 |
| Provider Name | Inga Simkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972949030 PECOS PAC ID: 5890925994 Enrollment ID: I20140312000794 |
| Provider Name | Rhea A Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174955702 PECOS PAC ID: 9032349055 Enrollment ID: I20140312002057 |
| Provider Name | Shawn A Denning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205177789 PECOS PAC ID: 3870723844 Enrollment ID: I20140313001349 |
| Provider Name | Jill K Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093065922 PECOS PAC ID: 2668603606 Enrollment ID: I20140315000209 |
| Provider Name | Satinderpal K Sandhu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912260944 PECOS PAC ID: 3971734781 Enrollment ID: I20140320000262 |
| Provider Name | Michelle Phillips-cottrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376979724 PECOS PAC ID: 2062643570 Enrollment ID: I20140326002158 |
| Provider Name | Raquel Martinez-alzate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780922377 PECOS PAC ID: 2466683800 Enrollment ID: I20140327001024 |
| Provider Name | Melody D Randle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326462854 PECOS PAC ID: 7719119486 Enrollment ID: I20140410002104 |
| Provider Name | Tyressa L Savage |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124360383 PECOS PAC ID: 6305078700 Enrollment ID: I20140417001959 |
| Provider Name | Eunice O Obamiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639437403 PECOS PAC ID: 1759514409 Enrollment ID: I20140502001071 |
| Provider Name | Jessica Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295146918 PECOS PAC ID: 9436374071 Enrollment ID: I20140715001778 |
| Provider Name | Jason Paul Levy |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710274022 PECOS PAC ID: 7416173786 Enrollment ID: I20140722001503 |
| Provider Name | Crystal N Gonzalez |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1326297144 PECOS PAC ID: 1759428006 Enrollment ID: I20140804000150 |
| Provider Name | William Robert Barker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396927364 PECOS PAC ID: 9739307190 Enrollment ID: I20140826002225 |
| Provider Name | Marina Gordeyeva |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104238740 PECOS PAC ID: 9931327145 Enrollment ID: I20140902000237 |
| Provider Name | Bibbin P George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780971028 PECOS PAC ID: 5092934489 Enrollment ID: I20140917001275 |
| Provider Name | John K Tompkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306247457 PECOS PAC ID: 2668794934 Enrollment ID: I20141124001512 |
| Provider Name | Mia F Harris |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1376944983 PECOS PAC ID: 3870815491 Enrollment ID: I20141209001502 |
| Provider Name | Heather C Wilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194123133 PECOS PAC ID: 4981920626 Enrollment ID: I20150224001112 |
| Provider Name | Omar Al Ustwani |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1275769978 PECOS PAC ID: 9830335330 Enrollment ID: I20150325000429 |
| Provider Name | Genean M Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336551456 PECOS PAC ID: 3870811581 Enrollment ID: I20150409000531 |
| Provider Name | Nicole Terrigno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679985097 PECOS PAC ID: 6406169127 Enrollment ID: I20150723007669 |
| Provider Name | Raechel A Fockler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780934042 PECOS PAC ID: 0143534115 Enrollment ID: I20150804005416 |
| Provider Name | Anne Walker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518077163 PECOS PAC ID: 9436057536 Enrollment ID: I20150904000061 |
| Provider Name | Nathaniel F Gabriel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104217488 PECOS PAC ID: 6204142201 Enrollment ID: I20150908000940 |
| Provider Name | Okebugwu Kamalu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053720847 PECOS PAC ID: 5991014847 Enrollment ID: I20151016000671 |
| Provider Name | Stephanie Flaherty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720414584 PECOS PAC ID: 3476856089 Enrollment ID: I20160114001358 |
| Provider Name | Shelly Yamasaki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548637440 PECOS PAC ID: 9537467527 Enrollment ID: I20160407000068 |
| Provider Name | Marie Gretta Bernard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760854533 PECOS PAC ID: 6709184765 Enrollment ID: I20160408000087 |
| Provider Name | Paula L Hasenauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346632452 PECOS PAC ID: 3375842867 Enrollment ID: I20160505000179 |
| Provider Name | Jason L Bartock |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316176043 PECOS PAC ID: 8224255641 Enrollment ID: I20160517001373 |
| Provider Name | Yostina Bichay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134567050 PECOS PAC ID: 4688967425 Enrollment ID: I20160801001724 |
| Provider Name | Karen Dong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255629424 PECOS PAC ID: 1052604816 Enrollment ID: I20160801002383 |
| Provider Name | Navjot Singh Grewal |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1245646231 PECOS PAC ID: 5395039358 Enrollment ID: I20160815000406 |
| Provider Name | Robert M Cole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235550195 PECOS PAC ID: 8921327537 Enrollment ID: I20160824002994 |
| Provider Name | Effat Jabeen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871901082 PECOS PAC ID: 6002101037 Enrollment ID: I20160830000079 |
| Provider Name | Aarti Aggarwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104192988 PECOS PAC ID: 2062654213 Enrollment ID: I20160830002925 |
| Provider Name | Sriharshan J Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972948016 PECOS PAC ID: 9133415631 Enrollment ID: I20160909000723 |
| Provider Name | Kajal Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881021509 PECOS PAC ID: 7618264680 Enrollment ID: I20160920001393 |
| Provider Name | Beth A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487106290 PECOS PAC ID: 0941580955 Enrollment ID: I20161209000151 |
| Provider Name | Kimbreya Otey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831632090 PECOS PAC ID: 7113209966 Enrollment ID: I20170131001448 |
| Provider Name | Latia M Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740640309 PECOS PAC ID: 6406139542 Enrollment ID: I20170215000867 |
| Provider Name | Gwen Mckenney |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619906500 PECOS PAC ID: 1951524925 Enrollment ID: I20170228001651 |
| Provider Name | Kimberly Geria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801266069 PECOS PAC ID: 2860777430 Enrollment ID: I20170322000425 |
| Provider Name | Josephine Quinn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831633387 PECOS PAC ID: 4183909773 Enrollment ID: I20170322001023 |
| Provider Name | Kristin Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215391610 PECOS PAC ID: 3678859816 Enrollment ID: I20170424001932 |
| Provider Name | John A Deleonardis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992851984 PECOS PAC ID: 1850678095 Enrollment ID: I20170426000444 |
| Provider Name | Lyndsay Hall |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710424031 PECOS PAC ID: 5496032443 Enrollment ID: I20170501001663 |
| Provider Name | Tina Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841613999 PECOS PAC ID: 2668759507 Enrollment ID: I20170503000400 |
| Provider Name | Stephanie Torres |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497152219 PECOS PAC ID: 9133406630 Enrollment ID: I20170511000158 |
| Provider Name | Amanda Lynn Ganza |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972845055 PECOS PAC ID: 3577833912 Enrollment ID: I20170718003044 |
| Provider Name | Adam Green |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871882258 PECOS PAC ID: 2668743550 Enrollment ID: I20170811000117 |
| Provider Name | Rocco Terrigno |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477975720 PECOS PAC ID: 7416229216 Enrollment ID: I20170814001955 |
| Provider Name | Elizabeth Noelle Clayton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932537529 PECOS PAC ID: 2567734437 Enrollment ID: I20170828002388 |
| Provider Name | Swarnalatha Neema |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033302120 PECOS PAC ID: 3274622873 Enrollment ID: I20170901002979 |
| Provider Name | Tiffany A Pompa |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1649558586 PECOS PAC ID: 2365715588 Enrollment ID: I20170908002261 |
| Provider Name | Sharad D Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1093943631 PECOS PAC ID: 2769649243 Enrollment ID: I20170925001209 |
| Provider Name | Andre C Gabriel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043630833 PECOS PAC ID: 4688949464 Enrollment ID: I20171004001247 |
| Provider Name | David Klatz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891219945 PECOS PAC ID: 0042585200 Enrollment ID: I20171013002460 |
| Provider Name | Vinay Motu Palli |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558776336 PECOS PAC ID: 8628344801 Enrollment ID: I20171017001628 |
| Provider Name | Himabindu M Lanka |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780964825 PECOS PAC ID: 9234447145 Enrollment ID: I20171019002796 |
| Provider Name | Priten C Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831530237 PECOS PAC ID: 5294002861 Enrollment ID: I20171204000226 |
| Provider Name | Joseph J Cipriano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922558683 PECOS PAC ID: 6800153693 Enrollment ID: I20171204001462 |
| Provider Name | Danielle L Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801312152 PECOS PAC ID: 3779840251 Enrollment ID: I20171208001850 |
| Provider Name | Himali S Wijesooriya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720219926 PECOS PAC ID: 9335375625 Enrollment ID: I20180104001421 |
| Provider Name | Mysti S Blizzard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982117339 PECOS PAC ID: 9638438781 Enrollment ID: I20180117001238 |
| Provider Name | Jacqueline Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255643615 PECOS PAC ID: 1052672888 Enrollment ID: I20180219001596 |
| Provider Name | Leannah L Harper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598708448 PECOS PAC ID: 1456612456 Enrollment ID: I20180308002115 |
| Provider Name | Michele Fortune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467957092 PECOS PAC ID: 5294080461 Enrollment ID: I20180613000274 |
| Provider Name | Cicily M Jeannette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902221864 PECOS PAC ID: 6305192188 Enrollment ID: I20180710000058 |
| Provider Name | Christopher Bartlett Noel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649699547 PECOS PAC ID: 5698078285 Enrollment ID: I20180724002583 |
| Provider Name | Daniel Scott Wilen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154702363 PECOS PAC ID: 6305193046 Enrollment ID: I20180726000263 |
| Provider Name | Nicholas Calder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477937217 PECOS PAC ID: 5991052649 Enrollment ID: I20180726000444 |
| Provider Name | Adip Pillai |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841685088 PECOS PAC ID: 7315296142 Enrollment ID: I20180828000111 |
| Provider Name | Fisayo O Tunde |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881195881 PECOS PAC ID: 5395096580 Enrollment ID: I20180927001343 |
| Provider Name | Jinal T Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710464110 PECOS PAC ID: 7416200514 Enrollment ID: I20181018002141 |
| Provider Name | Ellen M Mcginley |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1508341546 PECOS PAC ID: 1557615143 Enrollment ID: I20181119000291 |
| Provider Name | Tanuja M Rajpal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215254263 PECOS PAC ID: 9234377490 Enrollment ID: I20181129002083 |
| Provider Name | Jennifer L Farestad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992154132 PECOS PAC ID: 3274878343 Enrollment ID: I20181218000705 |
| Provider Name | Vikrant Kelvin Pandian |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1770804221 PECOS PAC ID: 2163650151 Enrollment ID: I20190201000838 |
| Provider Name | Melissa C Hetzell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942778592 PECOS PAC ID: 3476890138 Enrollment ID: I20190204001255 |
| Provider Name | Jose Luis Boggio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851490577 PECOS PAC ID: 5890715213 Enrollment ID: I20190208002210 |
| Provider Name | Eric John Carlson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316995574 PECOS PAC ID: 5294790648 Enrollment ID: I20190219000033 |
| Provider Name | Breshelle Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912470519 PECOS PAC ID: 5698014116 Enrollment ID: I20190228000705 |
| Provider Name | Michael Patrick Bonk |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801156195 PECOS PAC ID: 2769718964 Enrollment ID: I20190725002239 |
| Provider Name | Kimberly Gerardi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982265419 PECOS PAC ID: 0345576021 Enrollment ID: I20190802000501 |
| Provider Name | Tyler Webb Mcmillan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407202492 PECOS PAC ID: 2668763723 Enrollment ID: I20190809000483 |
| Provider Name | Danielle Chimento |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528412285 PECOS PAC ID: 7214265057 Enrollment ID: I20190819000629 |
| Provider Name | Shawana Hussain |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1699018911 PECOS PAC ID: 1759686744 Enrollment ID: I20190819002447 |
| Provider Name | Edmond Sarkis |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1427466010 PECOS PAC ID: 3870830458 Enrollment ID: I20190822001773 |
| Provider Name | Natallia Breibart |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487009114 PECOS PAC ID: 9436487741 Enrollment ID: I20190826000005 |
| Provider Name | Dominic A De Angelo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730549205 PECOS PAC ID: 5991080343 Enrollment ID: I20190826000058 |
| Provider Name | Kathryn Lien Haroldson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831544493 PECOS PAC ID: 7315237997 Enrollment ID: I20190828000911 |
| Provider Name | Cynthia A Ristine-burnley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134597362 PECOS PAC ID: 6608185517 Enrollment ID: I20190918000409 |
| Provider Name | Nicole M Babel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598328601 PECOS PAC ID: 6800228016 Enrollment ID: I20191108001515 |
| Provider Name | Jared Ward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669907309 PECOS PAC ID: 7113351271 Enrollment ID: I20191223001982 |
| Provider Name | Davina Ann Soernssen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861941841 PECOS PAC ID: 1658709191 Enrollment ID: I20200317001660 |
| Provider Name | Angel Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063059202 PECOS PAC ID: 2466880653 Enrollment ID: I20200323001169 |
| Provider Name | Seth A Finkelstein |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790754034 PECOS PAC ID: 8820093388 Enrollment ID: I20200625001621 |
| Provider Name | Fahim Hasani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891221578 PECOS PAC ID: 9739502568 Enrollment ID: I20200713000282 |
| Provider Name | Andrew Gregory Ajemian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255851317 PECOS PAC ID: 9436573029 Enrollment ID: I20200715001849 |
| Provider Name | Kelly F Quick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447885660 PECOS PAC ID: 7719302116 Enrollment ID: I20200803000040 |
| Provider Name | Vede James Ramdass |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780107482 PECOS PAC ID: 0648696401 Enrollment ID: I20200811003870 |
| Provider Name | Dennis Hoon Kwon |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1467865261 PECOS PAC ID: 7416246061 Enrollment ID: I20200819001363 |
| Provider Name | Laura E Roettger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336394972 PECOS PAC ID: 8527485275 Enrollment ID: I20200827000004 |
| Provider Name | Kwaku Ohene Asare |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962847509 PECOS PAC ID: 3779727169 Enrollment ID: I20201102000593 |
| Provider Name | Courtney A Destefano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780219410 PECOS PAC ID: 1254741226 Enrollment ID: I20201102002195 |
| Provider Name | Michael Gross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396037313 PECOS PAC ID: 6507005444 Enrollment ID: I20201211000420 |
| Provider Name | Kyle C Niziolek |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1427314095 PECOS PAC ID: 2769621333 Enrollment ID: I20210315000896 |
| Provider Name | George Henry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932179090 PECOS PAC ID: 0648288746 Enrollment ID: I20210317001436 |
| Provider Name | Shipra Prasad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346849700 PECOS PAC ID: 8527477231 Enrollment ID: I20210511000227 |
| Provider Name | Deena Lee Nakpodia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528699220 PECOS PAC ID: 3274942909 Enrollment ID: I20210511000960 |
| Provider Name | Molly K Dejesus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750985388 PECOS PAC ID: 0244639268 Enrollment ID: I20210525001309 |
| Provider Name | Yanika Wolfe |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1538574108 PECOS PAC ID: 2567717077 Enrollment ID: I20210706000037 |
| Provider Name | Christopher David Perez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184104911 PECOS PAC ID: 8820491293 Enrollment ID: I20210722001273 |
| Provider Name | Parth Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093212144 PECOS PAC ID: 9032461843 Enrollment ID: I20210727000879 |
| Provider Name | Joseph Arthur Grogg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942797857 PECOS PAC ID: 1658626288 Enrollment ID: I20210729002449 |
| Provider Name | Gregory Hilditch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033697834 PECOS PAC ID: 8921401720 Enrollment ID: I20210729004060 |
| Provider Name | Anita Sargent |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053586966 PECOS PAC ID: 5193981637 Enrollment ID: I20210802002617 |
| Provider Name | Lindsey J Glaspey |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1396280202 PECOS PAC ID: 2264836949 Enrollment ID: I20210803000021 |
| Provider Name | Dale Lacroix |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922034479 PECOS PAC ID: 8921185554 Enrollment ID: I20210803000541 |
| Provider Name | Matthew Thomas Springer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144727561 PECOS PAC ID: 9931504776 Enrollment ID: I20210817003499 |
| Provider Name | Justin K Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962822593 PECOS PAC ID: 6608170683 Enrollment ID: I20210818001963 |
| Provider Name | Viergina L Dudley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164990909 PECOS PAC ID: 7214333566 Enrollment ID: I20210911000148 |
| Provider Name | Fawaz Anwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942793187 PECOS PAC ID: 9335546431 Enrollment ID: I20210915003577 |
| Provider Name | Darrien P Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699448043 PECOS PAC ID: 3072911833 Enrollment ID: I20211007003158 |
| Provider Name | Rodrigo Fernandez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215463807 PECOS PAC ID: 7315281425 Enrollment ID: I20211008000992 |
| Provider Name | Bruce Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952668824 PECOS PAC ID: 5395058929 Enrollment ID: I20211018000007 |
| Provider Name | Rhea Farquhar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427548841 PECOS PAC ID: 5698165769 Enrollment ID: I20211203000597 |
| Provider Name | Matthew Mcmullan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1356705792 PECOS PAC ID: 7810244712 Enrollment ID: I20211220000673 |
| Provider Name | Krystal L Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356000343 PECOS PAC ID: 3173915881 Enrollment ID: I20220108000108 |
| Provider Name | Scott E Hirst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194489294 PECOS PAC ID: 6800288069 Enrollment ID: I20220120000042 |
| Provider Name | Nicholas R Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396270393 PECOS PAC ID: 9032488820 Enrollment ID: I20220426001294 |
| Provider Name | Christine Medeiros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801321427 PECOS PAC ID: 5698157071 Enrollment ID: I20220802000417 |
| Provider Name | Gabriela J Contino |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689170508 PECOS PAC ID: 1759625395 Enrollment ID: I20220803001383 |
| Provider Name | Gabrielle L Rizzo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1467184549 PECOS PAC ID: 6406230499 Enrollment ID: I20220824002883 |
| Provider Name | Gabriele E Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790103752 PECOS PAC ID: 8022234939 Enrollment ID: I20220912003025 |
| Provider Name | Bali K Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316409634 PECOS PAC ID: 5890163133 Enrollment ID: I20221117002946 |
| Provider Name | Nantale Nsibirwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982338489 PECOS PAC ID: 1759753148 Enrollment ID: I20230213000917 |
| Provider Name | Yvette J Dancel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780309252 PECOS PAC ID: 7214301381 Enrollment ID: I20230314000329 |
| Provider Name | Nathan P Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639740020 PECOS PAC ID: 1254706765 Enrollment ID: I20230416000037 |
| Provider Name | Mojisola Dabney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326736620 PECOS PAC ID: 9234307752 Enrollment ID: I20230601001038 |
| Provider Name | Minesh T Nandi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1306376421 PECOS PAC ID: 7810307717 Enrollment ID: I20230712002035 |
| Provider Name | Yasir Y Khan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1861843138 PECOS PAC ID: 4880987676 Enrollment ID: I20230814000569 |
| Provider Name | Prarthi R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821626409 PECOS PAC ID: 4880057488 Enrollment ID: I20230830001372 |
| Provider Name | Robin Y Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184324790 PECOS PAC ID: 0042664815 Enrollment ID: I20230927002705 |
| Provider Name | O'neil Chaudhry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699396275 PECOS PAC ID: 4385099613 Enrollment ID: I20231006000569 |
| Provider Name | Kristianne Amurao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225650856 PECOS PAC ID: 7517380397 Enrollment ID: I20231019003622 |
| Provider Name | Mohamed H Salah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396265971 PECOS PAC ID: 3577951052 Enrollment ID: I20231023000652 |
| Provider Name | Hely Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346744604 PECOS PAC ID: 5991055352 Enrollment ID: I20231026002680 |
| Provider Name | Prateek Juneja |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1962996330 PECOS PAC ID: 8022464627 Enrollment ID: I20231101003071 |
| Provider Name | Ryan Liu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730702143 PECOS PAC ID: 4880015510 Enrollment ID: I20231102003258 |
| Provider Name | Amy C Vazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881479939 PECOS PAC ID: 5294186821 Enrollment ID: I20240109000780 |
| Provider Name | Gina C Krementz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225813850 PECOS PAC ID: 7113378498 Enrollment ID: I20240111000646 |
Bridgeton Medical Associates Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 105 Manheim Ave, Suite 1, Bridgeton, NJ 08302 Phone: 856-455-2700 Fax: 856-455-7051 | |
Cumberland Dental Associates Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 553 Shiloh Pike, Bridgeton, NJ 08302 Phone: 856-451-9064 Fax: 856-451-8414 | |
Completecare Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 265 Irving Ave, Bridgeton, NJ 08302 Phone: 856-451-4700 Fax: 856-451-8685 | |
Jack M. Shields,m.d., Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20 Magnolia Ave, Building B , Suite C, Bridgeton, NJ 08302 Phone: 856-455-8833 | |
Sherrie Colaneriday Npc Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 N Pearl St, Bridgeton, NJ 08302 Phone: 856-455-1800 Fax: 856-455-7765 | |
Daniel Manske Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 154 W Commerce St, Bridgeton, NJ 08302 Phone: 856-459-3500 Fax: 856-459-3600 | |
Family Practice Associates Of Cumberland Co Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 230 Laurel Heights Drive, Bridgeton, NJ 08302 Phone: 856-451-9595 Fax: 856-451-4130 |