Corelife | |
200 E Vine St Ste B Salisbury MD 21804-5531 | |
(443) 358-6239 | |
Not Available |
Full Name | Corelife |
---|---|
Speciality | Family Medicine |
Location | 200 E Vine St Ste B, Salisbury, Maryland |
Authorized Official Name and Position | Raymond Kostkowski (CEO) |
Authorized Official Contact | 4436794309 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Corelife 1111 Benfield Blvd Ste 250 Millersville MD 21108-3005 Ph: (443) 679-4309 | Corelife 200 E Vine St Ste B Salisbury MD 21804-5531 Ph: (443) 358-6239 |
NPI Number | 1477063386 |
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Provider Enumeration Date | 10/05/2017 |
Last Update Date | 03/31/2021 |
Medicare PECOS PAC ID | 8628337177 |
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Medicare Enrollment ID | O20180109002027 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477063386 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Stephan R Izzi |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629079173 PECOS PAC ID: 2567505811 Enrollment ID: I20100209000016 |
Provider Name | Constance E Ikonomou |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841580610 PECOS PAC ID: 9234315516 Enrollment ID: I20110714000110 |
Provider Name | Steven Donnelly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588912232 PECOS PAC ID: 2860647278 Enrollment ID: I20130308000148 |
Provider Name | Vincent Stephan Izzi |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467832683 PECOS PAC ID: 7719282219 Enrollment ID: I20180921000021 |
Provider Name | Ashley Schmitz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528541802 PECOS PAC ID: 9032461132 Enrollment ID: I20181017001561 |
Provider Name | John A Hancock |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063909398 PECOS PAC ID: 6709123078 Enrollment ID: I20190124000435 |
Provider Name | Lori Economos |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205970100 PECOS PAC ID: 8426395310 Enrollment ID: I20190131000418 |
Provider Name | Alyson N Heenan |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1285106393 PECOS PAC ID: 6204174949 Enrollment ID: I20190205001880 |
Provider Name | Nicholas Fischer |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1124465349 PECOS PAC ID: 9436498201 Enrollment ID: I20190222002102 |
Provider Name | Bobbi Graef |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881781805 PECOS PAC ID: 8426398009 Enrollment ID: I20190318001820 |
Provider Name | Racheal Torcisi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801352000 PECOS PAC ID: 9739429374 Enrollment ID: I20190319001601 |
Provider Name | Hillary A Miranda |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720441405 PECOS PAC ID: 5991045130 Enrollment ID: I20190325002682 |
Provider Name | Karoline Pugh |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1891254033 PECOS PAC ID: 4385985787 Enrollment ID: I20190412000436 |
Provider Name | Andrew Mnt Hade |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1386117307 PECOS PAC ID: 0749522431 Enrollment ID: I20190429002382 |
Provider Name | Melisa D Zamora |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184042251 PECOS PAC ID: 6800165648 Enrollment ID: I20190502001506 |
Provider Name | Lauren Holfeld |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1366006637 PECOS PAC ID: 5193068898 Enrollment ID: I20190521002022 |
Provider Name | Hewan Chekol |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710539929 PECOS PAC ID: 0345577268 Enrollment ID: I20190814002934 |
Provider Name | Ann Aldrich |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437713542 PECOS PAC ID: 8921332131 Enrollment ID: I20190917000365 |
Provider Name | Sandra Gassant |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194283184 PECOS PAC ID: 8921430109 Enrollment ID: I20191108000295 |
Provider Name | Adeleh Kooshki |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124332770 PECOS PAC ID: 1850683228 Enrollment ID: I20191220000087 |
Provider Name | Jennifer George |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1417596347 PECOS PAC ID: 1153757760 Enrollment ID: I20200130000353 |
Provider Name | Karen Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073724555 PECOS PAC ID: 0840374526 Enrollment ID: I20200226001968 |
Provider Name | Camille Zentkovich |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245795129 PECOS PAC ID: 3779910880 Enrollment ID: I20200303000651 |
Provider Name | Maria Francesca Mura |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1124475801 PECOS PAC ID: 8123456894 Enrollment ID: I20200311000508 |
Provider Name | Arin Calderwood |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1487204913 PECOS PAC ID: 5991037152 Enrollment ID: I20200319000106 |
Provider Name | Ali Zentgraf Era |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598375560 PECOS PAC ID: 9436576055 Enrollment ID: I20200827003027 |
Provider Name | Chelsea Halsman |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1609494921 PECOS PAC ID: 9133549843 Enrollment ID: I20201019002940 |
Provider Name | Rachel Goldsborough |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437752086 PECOS PAC ID: 2365854320 Enrollment ID: I20201215002990 |
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