| Wellspan Family Medicine | |
|
1 Hospital Dr Lewisburg PA 17837-9350 | |
| (570) 522-4110 | |
| (570) 768-3911 |
| Full Name | Wellspan Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Hospital Dr, Lewisburg, Pennsylvania |
| Authorized Official Name and Position | Kendra A Aucker (SENIOR VICE PRESIDENT/PRESIDENT) |
| Authorized Official Contact | 5705222807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspan Family Medicine 1 Hospital Dr Suite 306 Lewisburg PA 17837-9350 Ph: (570) 522-4110 | Wellspan Family Medicine 1 Hospital Dr Lewisburg PA 17837-9350 Ph: (570) 522-4110 |
| NPI Number | 1295834984 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 09/06/2024 |
| Medicare PECOS PAC ID | 9133033087 |
|---|---|
| Medicare Enrollment ID | O20040310000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295834984 | NPI | - | NPPES |
| 50062067 | Other | PA | CAPITAL BLUE CROSS |
| 118438703 | Other | PA | DEPARTMENT OF LABOR |
| 001881626 | Other | PA | HIGHMARK BLUE SHIELD |
| CA5965 | Other | PA | RAILROAD MEDICARE |
| 1007498260092 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Dawn A Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144269275 PECOS PAC ID: 3779482674 Enrollment ID: I20040108000497 |
| Provider Name | Joseph M Mucciolo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447228366 PECOS PAC ID: 0941101182 Enrollment ID: I20040120000300 |
| Provider Name | Sandra S Walker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134114721 PECOS PAC ID: 5496657538 Enrollment ID: I20040121000279 |
| Provider Name | Ray T Douglas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184643488 PECOS PAC ID: 6406758390 Enrollment ID: I20040122000091 |
| Provider Name | Thomas A Krebs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972522373 PECOS PAC ID: 1052213956 Enrollment ID: I20040122000160 |
| Provider Name | Rajiv Dhawan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710967005 PECOS PAC ID: 8426950791 Enrollment ID: I20040126000833 |
| Provider Name | Mark A Blakeslee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154340461 PECOS PAC ID: 9931001112 Enrollment ID: I20040127000507 |
| Provider Name | Diane M Mcclain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982604393 PECOS PAC ID: 6204723737 Enrollment ID: I20040301000603 |
| Provider Name | James R Patterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952320384 PECOS PAC ID: 2062300726 Enrollment ID: I20040305000460 |
| Provider Name | Peter Hannon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811943335 PECOS PAC ID: 1557359783 Enrollment ID: I20040505000611 |
| Provider Name | Frank A Maffei |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356302079 PECOS PAC ID: 2860483054 Enrollment ID: I20040518000919 |
| Provider Name | Thomas R Westenberger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972643864 PECOS PAC ID: 5991786048 Enrollment ID: I20040526000158 |
| Provider Name | John Keith Mcilwaine |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1346249125 PECOS PAC ID: 5193702355 Enrollment ID: I20040706000724 |
| Provider Name | Arun Seth |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124111612 PECOS PAC ID: 2365421625 Enrollment ID: I20040719001408 |
| Provider Name | Russell J Stankiewicz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891773875 PECOS PAC ID: 1951373562 Enrollment ID: I20040812000550 |
| Provider Name | Angela W Cassel |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1487620290 PECOS PAC ID: 5496727034 Enrollment ID: I20040812000790 |
| Provider Name | William E Sotack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225080823 PECOS PAC ID: 1153397633 Enrollment ID: I20040907000537 |
| Provider Name | Thomas C Smith |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326067059 PECOS PAC ID: 8224004213 Enrollment ID: I20040910000055 |
| Provider Name | John E Rice |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396764015 PECOS PAC ID: 7012985203 Enrollment ID: I20040924000602 |
| Provider Name | David G Talabiska |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922080274 PECOS PAC ID: 7719956283 Enrollment ID: I20040930000910 |
| Provider Name | Patrick Thomas Konitzer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487745311 PECOS PAC ID: 4880681931 Enrollment ID: I20041013000626 |
| Provider Name | Suzanne Greb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780609701 PECOS PAC ID: 0143281345 Enrollment ID: I20041021000265 |
| Provider Name | Patrick C Mckillion |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1114998804 PECOS PAC ID: 8921064601 Enrollment ID: I20041206000377 |
| Provider Name | Jeffrey Scott Taylor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598713315 PECOS PAC ID: 5698732402 Enrollment ID: I20041214000231 |
| Provider Name | Traci Louise Farley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376564013 PECOS PAC ID: 4981669561 Enrollment ID: I20041230000544 |
| Provider Name | Thomas Donald Scott |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740247808 PECOS PAC ID: 5890743462 Enrollment ID: I20050111000170 |
| Provider Name | Nicholas A Inverso |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396704086 PECOS PAC ID: 6002865912 Enrollment ID: I20050118000926 |
| Provider Name | Thomas Louis Martin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942279559 PECOS PAC ID: 2961492376 Enrollment ID: I20050120000008 |
| Provider Name | John P Furia |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114996121 PECOS PAC ID: 1951391358 Enrollment ID: I20050120000013 |
| Provider Name | Theresa K Kelly |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003087776 PECOS PAC ID: 4082668660 Enrollment ID: I20050307000370 |
| Provider Name | Vickie Varklet |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346237427 PECOS PAC ID: 0749221117 Enrollment ID: I20050516000780 |
| Provider Name | David M Zelechoski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356360085 PECOS PAC ID: 6800839887 Enrollment ID: I20050610000095 |
| Provider Name | Kathryn A Krisko-stokes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336117654 PECOS PAC ID: 4082659057 Enrollment ID: I20050621001129 |
| Provider Name | Anwer Qureshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588629521 PECOS PAC ID: 9537104351 Enrollment ID: I20050622001037 |
| Provider Name | Brian A Batman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235108952 PECOS PAC ID: 3779528260 Enrollment ID: I20050624000572 |
| Provider Name | Gerard J Cush |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225004542 PECOS PAC ID: 2860459971 Enrollment ID: I20050712000616 |
| Provider Name | Robert Scott |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215969365 PECOS PAC ID: 8820027386 Enrollment ID: I20050805000261 |
| Provider Name | Michael C Marino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083696264 PECOS PAC ID: 9436182060 Enrollment ID: I20050914001094 |
| Provider Name | Colleen A Fritz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558398776 PECOS PAC ID: 5991730558 Enrollment ID: I20051003000237 |
| Provider Name | Paul W Sokoloski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740228535 PECOS PAC ID: 9234157207 Enrollment ID: I20051108000724 |
| Provider Name | Raymond J Tomaszewski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316936313 PECOS PAC ID: 3870517345 Enrollment ID: I20060124000105 |
| Provider Name | Sam S Bang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447224118 PECOS PAC ID: 0840265047 Enrollment ID: I20060130000448 |
| Provider Name | Aida Elbarbary |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275505497 PECOS PAC ID: 0648285114 Enrollment ID: I20060221000159 |
| Provider Name | Mary M Weisbrod |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1265486377 PECOS PAC ID: 1951310424 Enrollment ID: I20060411000435 |
| Provider Name | Sandra K Charles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093734436 PECOS PAC ID: 0244240836 Enrollment ID: I20060426000843 |
| Provider Name | Matthew Joshua Shellenberger |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619911237 PECOS PAC ID: 6901818301 Enrollment ID: I20060630000092 |
| Provider Name | Lori Kaye Rothermel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942220983 PECOS PAC ID: 7113922964 Enrollment ID: I20060929000016 |
| Provider Name | Michael J Starr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851311880 PECOS PAC ID: 3072518737 Enrollment ID: I20061002000444 |
| Provider Name | Frederick C Lapp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801816848 PECOS PAC ID: 5698771129 Enrollment ID: I20061006000010 |
| Provider Name | Maria Mabel Fasano |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1083634018 PECOS PAC ID: 5496751935 Enrollment ID: I20061006000029 |
| Provider Name | Lisa Skultety Ayers |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538183892 PECOS PAC ID: 1254337637 Enrollment ID: I20061006000326 |
| Provider Name | Randi James Mcleod |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114972320 PECOS PAC ID: 8628982568 Enrollment ID: I20061012000520 |
| Provider Name | Debra S Moore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225109556 PECOS PAC ID: 4183623820 Enrollment ID: I20061207000166 |
| Provider Name | Kevin L Pigos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861400251 PECOS PAC ID: 7517934425 Enrollment ID: I20061221000131 |
| Provider Name | Donald Thomas Hall |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295793685 PECOS PAC ID: 7618977463 Enrollment ID: I20070102000201 |
| Provider Name | Matthew R Eager |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699830133 PECOS PAC ID: 6305847344 Enrollment ID: I20070118000207 |
| Provider Name | Doyle D Ashburn |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1245204395 PECOS PAC ID: 8426050048 Enrollment ID: I20070212000363 |
| Provider Name | Gregory H Enders |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639251820 PECOS PAC ID: 3577667674 Enrollment ID: I20070329000411 |
| Provider Name | Heather A Morphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912908294 PECOS PAC ID: 4385624030 Enrollment ID: I20070419000075 |
| Provider Name | John F Devine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780633842 PECOS PAC ID: 8628174737 Enrollment ID: I20070507000544 |
| Provider Name | Matthew W Reish |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477685105 PECOS PAC ID: 5193820686 Enrollment ID: I20070710000171 |
| Provider Name | Jon D Gabrielsen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093829939 PECOS PAC ID: 8426157900 Enrollment ID: I20070711000550 |
| Provider Name | Michael L Adler |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568432136 PECOS PAC ID: 8729010442 Enrollment ID: I20070917000646 |
| Provider Name | Thomas E Mowry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740470103 PECOS PAC ID: 3779671375 Enrollment ID: I20071115000291 |
| Provider Name | Joyce A Burnside |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568437457 PECOS PAC ID: 2961587076 Enrollment ID: I20080313000593 |
| Provider Name | Stuart N Hoffman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649249848 PECOS PAC ID: 3476639717 Enrollment ID: I20080326000724 |
| Provider Name | Scott M Friedenburg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811964893 PECOS PAC ID: 1850478124 Enrollment ID: I20080410000522 |
| Provider Name | Corinne W Kleman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609835974 PECOS PAC ID: 0749368223 Enrollment ID: I20080424000054 |
| Provider Name | Gary S Ayers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891962031 PECOS PAC ID: 3971677709 Enrollment ID: I20080728000753 |
| Provider Name | Alberto Unzueta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1558521831 PECOS PAC ID: 3072689363 Enrollment ID: I20080911000019 |
| Provider Name | Beth Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548222433 PECOS PAC ID: 1456427665 Enrollment ID: I20080911000287 |
| Provider Name | James S Callaghan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528275443 PECOS PAC ID: 7416018874 Enrollment ID: I20081204000403 |
| Provider Name | John Hodgson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669586269 PECOS PAC ID: 4284697616 Enrollment ID: I20081230000210 |
| Provider Name | Daniel J Lovestrand |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164531208 PECOS PAC ID: 3779645577 Enrollment ID: I20090102000060 |
| Provider Name | Max A Yesalavage |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851543516 PECOS PAC ID: 5799849303 Enrollment ID: I20090127000259 |
| Provider Name | Jennifer A Sheaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336393651 PECOS PAC ID: 9436215480 Enrollment ID: I20090227000251 |
| Provider Name | Joel I Wagman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609860519 PECOS PAC ID: 0345209698 Enrollment ID: I20090618000055 |
| Provider Name | David Greenblatt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063467249 PECOS PAC ID: 3072664788 Enrollment ID: I20090619000069 |
| Provider Name | Jason A Stamm |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1104857713 PECOS PAC ID: 2769533868 Enrollment ID: I20090701000287 |
| Provider Name | Amitpal S Johal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720245137 PECOS PAC ID: 3779635594 Enrollment ID: I20090708000760 |
| Provider Name | Scott Jeffries |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659524387 PECOS PAC ID: 1052465846 Enrollment ID: I20090813000059 |
| Provider Name | Krystal G Strazik |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1063641215 PECOS PAC ID: 5193870137 Enrollment ID: I20090827000346 |
| Provider Name | Daniel J Mulligan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386978401 PECOS PAC ID: 4688711120 Enrollment ID: I20091102000404 |
| Provider Name | Shuping Ge |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811077167 PECOS PAC ID: 1557323474 Enrollment ID: I20091112000509 |
| Provider Name | Kirti Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689815680 PECOS PAC ID: 6507905650 Enrollment ID: I20091202000360 |
| Provider Name | Gregory A Stone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528083532 PECOS PAC ID: 2264572841 Enrollment ID: I20091211000246 |
| Provider Name | Michael D Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386614063 PECOS PAC ID: 9931242724 Enrollment ID: I20100202000388 |
| Provider Name | James W Morgan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285602201 PECOS PAC ID: 5294712386 Enrollment ID: I20100301000677 |
| Provider Name | Seth I Weber |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891763892 PECOS PAC ID: 8921143371 Enrollment ID: I20100310000017 |
| Provider Name | Christopher Brancato |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285691758 PECOS PAC ID: 4587668710 Enrollment ID: I20100511000556 |
| Provider Name | Kathryn M Giorgini |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1295930378 PECOS PAC ID: 8325178288 Enrollment ID: I20100621000085 |
| Provider Name | Brendon R Nolt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780887752 PECOS PAC ID: 3678603552 Enrollment ID: I20100621000255 |
| Provider Name | George C Miller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790757458 PECOS PAC ID: 1557498037 Enrollment ID: I20100810000968 |
| Provider Name | Charles Louis Cole |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023012861 PECOS PAC ID: 2163412552 Enrollment ID: I20100813000103 |
| Provider Name | Thomas F Dominick |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528028883 PECOS PAC ID: 6204826605 Enrollment ID: I20100813000661 |
| Provider Name | Paul Stephen Lin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629047246 PECOS PAC ID: 4082604475 Enrollment ID: I20100816000109 |
| Provider Name | Loretta Derrick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316932304 PECOS PAC ID: 4082739537 Enrollment ID: I20100921000606 |
| Provider Name | Kimberly J Criswell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1689986697 PECOS PAC ID: 4486849007 Enrollment ID: I20101109000895 |
| Provider Name | George Tenedios |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922009992 PECOS PAC ID: 1951301712 Enrollment ID: I20101210000205 |
| Provider Name | Christopher J Motto |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710955638 PECOS PAC ID: 0547305153 Enrollment ID: I20101229000994 |
| Provider Name | John F Turner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700854726 PECOS PAC ID: 1951375039 Enrollment ID: I20101230000103 |
| Provider Name | Todd M Stefan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1477521391 PECOS PAC ID: 2264406347 Enrollment ID: I20101230000355 |
| Provider Name | Janice Omlor |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174524623 PECOS PAC ID: 2264526938 Enrollment ID: I20110119000926 |
| Provider Name | Heather D Hottenstein |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1205136033 PECOS PAC ID: 8224218748 Enrollment ID: I20110215000766 |
| Provider Name | Lisa A Mucciolo |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1770575219 PECOS PAC ID: 2062693005 Enrollment ID: I20110223000618 |
| Provider Name | Janine A Gerringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518276187 PECOS PAC ID: 8426239021 Enrollment ID: I20110301000824 |
| Provider Name | Tolulope Mathias Olasunkanmi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558500447 PECOS PAC ID: 7012054695 Enrollment ID: I20110308000210 |
| Provider Name | Cindy J Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831490283 PECOS PAC ID: 5294917571 Enrollment ID: I20110308000441 |
| Provider Name | Martin A Albornoz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780687178 PECOS PAC ID: 3779548458 Enrollment ID: I20110325000425 |
| Provider Name | William Haynos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093786923 PECOS PAC ID: 0941288468 Enrollment ID: I20110509000549 |
| Provider Name | Sagar Mehta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205002276 PECOS PAC ID: 8426228461 Enrollment ID: I20110830000155 |
| Provider Name | Ayn H Kerber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750546867 PECOS PAC ID: 2365613981 Enrollment ID: I20110912000335 |
| Provider Name | Jack S. Bogart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790066223 PECOS PAC ID: 2769653443 Enrollment ID: I20110929000526 |
| Provider Name | Sonia L Reich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821377227 PECOS PAC ID: 8921270406 Enrollment ID: I20111005000215 |
| Provider Name | Amanda M Kissinger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245511393 PECOS PAC ID: 8123293883 Enrollment ID: I20111207000452 |
| Provider Name | Frank Joseph Lodeserto |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1326242173 PECOS PAC ID: 8527233667 Enrollment ID: I20111219000554 |
| Provider Name | Julia E Redcay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881672871 PECOS PAC ID: 9032184809 Enrollment ID: I20120216000391 |
| Provider Name | Karen A Korzick |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1750322509 PECOS PAC ID: 9537261797 Enrollment ID: I20120507000270 |
| Provider Name | Sandy M Green |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1225164973 PECOS PAC ID: 5991969313 Enrollment ID: I20120615000379 |
| Provider Name | Katherine Sprague Patil |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1023286929 PECOS PAC ID: 9032374632 Enrollment ID: I20120705000393 |
| Provider Name | Drew A Hampton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093071110 PECOS PAC ID: 2860658507 Enrollment ID: I20120724000543 |
| Provider Name | Abbas K Ali |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1154464162 PECOS PAC ID: 9537182696 Enrollment ID: I20120806000660 |
| Provider Name | Jeffrey M Aversa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992850887 PECOS PAC ID: 4082602644 Enrollment ID: I20120813000061 |
| Provider Name | Sharon A Novack |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679834170 PECOS PAC ID: 5294981973 Enrollment ID: I20120813000248 |
| Provider Name | Kay E Zlockie |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1184602179 PECOS PAC ID: 9931205812 Enrollment ID: I20121005000397 |
| Provider Name | Angela B Kline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487904827 PECOS PAC ID: 6002065711 Enrollment ID: I20121012000158 |
| Provider Name | Brent M Carpenter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912266685 PECOS PAC ID: 3577712249 Enrollment ID: I20121012000743 |
| Provider Name | Phillip Robert Peterson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003137613 PECOS PAC ID: 8628218492 Enrollment ID: I20130628000495 |
| Provider Name | Tariq Ali Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437472941 PECOS PAC ID: 5597908046 Enrollment ID: I20130830000565 |
| Provider Name | Lauren A Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326488677 PECOS PAC ID: 5395988695 Enrollment ID: I20130906000136 |
| Provider Name | Kelly J Baldwin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467695437 PECOS PAC ID: 7618101429 Enrollment ID: I20131010001144 |
| Provider Name | Christopher Lee Cummings |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053518191 PECOS PAC ID: 2961673934 Enrollment ID: I20131010001515 |
| Provider Name | Meredith M Rhodes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649605999 PECOS PAC ID: 0244465474 Enrollment ID: I20131024001152 |
| Provider Name | Gregory W Yost |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558500280 PECOS PAC ID: 4789819939 Enrollment ID: I20131024001582 |
| Provider Name | Evelyn Mai |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1538360904 PECOS PAC ID: 1850459348 Enrollment ID: I20131106001428 |
| Provider Name | Yassir Nawaz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1912139627 PECOS PAC ID: 9931346848 Enrollment ID: I20131107001047 |
| Provider Name | George H Baffoe Bonnie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780642090 PECOS PAC ID: 6901808435 Enrollment ID: I20140208000015 |
| Provider Name | Srinath Kadimi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730144734 PECOS PAC ID: 9931394715 Enrollment ID: I20140306001775 |
| Provider Name | Anya Chandler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730354507 PECOS PAC ID: 2860625191 Enrollment ID: I20140512001271 |
| Provider Name | Brian Nungesser |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265854376 PECOS PAC ID: 5890910004 Enrollment ID: I20140702000414 |
| Provider Name | Vishal Mehra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306934740 PECOS PAC ID: 5496704959 Enrollment ID: I20140702000510 |
| Provider Name | Malcolm O Mar Fan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477849255 PECOS PAC ID: 1355567322 Enrollment ID: I20140728001988 |
| Provider Name | Patrick Dacquel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134414899 PECOS PAC ID: 5294952560 Enrollment ID: I20140811000109 |
| Provider Name | Allison Anne Mcowen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457615197 PECOS PAC ID: 2668691387 Enrollment ID: I20140911001107 |
| Provider Name | David M Ermak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689816787 PECOS PAC ID: 2668613852 Enrollment ID: I20140925001106 |
| Provider Name | Neil Holland |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366408767 PECOS PAC ID: 3870687767 Enrollment ID: I20140929000297 |
| Provider Name | Karen Johnson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417190554 PECOS PAC ID: 5991925612 Enrollment ID: I20141001001187 |
| Provider Name | Brian J Connolly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245524214 PECOS PAC ID: 6608198809 Enrollment ID: I20141125000427 |
| Provider Name | Barbara J Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033503321 PECOS PAC ID: 0840519823 Enrollment ID: I20150427000390 |
| Provider Name | John M Pfeifer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104845395 PECOS PAC ID: 8820093180 Enrollment ID: I20150514001890 |
| Provider Name | William K Flatley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790058683 PECOS PAC ID: 7416278981 Enrollment ID: I20150609001992 |
| Provider Name | Nicolas N Mead |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548433758 PECOS PAC ID: 6901117993 Enrollment ID: I20150617001358 |
| Provider Name | Daria Lin Keyser |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922329259 PECOS PAC ID: 6800109190 Enrollment ID: I20150715001542 |
| Provider Name | Justin Stone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285923532 PECOS PAC ID: 7911136650 Enrollment ID: I20150716001236 |
| Provider Name | Kiera N Zarick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508253972 PECOS PAC ID: 7911210604 Enrollment ID: I20150724009864 |
| Provider Name | Adebukola M Ogundoyin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235495268 PECOS PAC ID: 4789900564 Enrollment ID: I20150730011565 |
| Provider Name | Jeanne M Vesnefskie |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1326433905 PECOS PAC ID: 5395059562 Enrollment ID: I20150731015766 |
| Provider Name | Flower Austin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1538470091 PECOS PAC ID: 0446565527 Enrollment ID: I20150819006365 |
| Provider Name | Laura M Grangeia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568751055 PECOS PAC ID: 2860629706 Enrollment ID: I20150828000325 |
| Provider Name | Laura D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912374067 PECOS PAC ID: 9931416559 Enrollment ID: I20150915001631 |
| Provider Name | Preet Varade |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467780551 PECOS PAC ID: 3870801657 Enrollment ID: I20150928001646 |
| Provider Name | Songoli Umeh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356635163 PECOS PAC ID: 6709194541 Enrollment ID: I20150929001024 |
| Provider Name | Kristina F Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912204074 PECOS PAC ID: 5698083871 Enrollment ID: I20151008000502 |
| Provider Name | Eugenia Kevelyuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073801502 PECOS PAC ID: 1355650235 Enrollment ID: I20151015000256 |
| Provider Name | Amy S Wirtner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851441323 PECOS PAC ID: 2062431315 Enrollment ID: I20151221001877 |
| Provider Name | Michael Katsnelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013170067 PECOS PAC ID: 6406989177 Enrollment ID: I20160111002640 |
| Provider Name | Sufana Zafar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386855781 PECOS PAC ID: 6204131493 Enrollment ID: I20160225002117 |
| Provider Name | Simon Iroha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194973503 PECOS PAC ID: 2567636038 Enrollment ID: I20160425000194 |
| Provider Name | Rany T Abdallah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679884977 PECOS PAC ID: 5294025748 Enrollment ID: I20160613000570 |
| Provider Name | Bradley D Confer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518132612 PECOS PAC ID: 4688845688 Enrollment ID: I20160629000032 |
| Provider Name | Anthony Noto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518256536 PECOS PAC ID: 7012209927 Enrollment ID: I20160714000116 |
| Provider Name | Roslyn Feaster |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003277617 PECOS PAC ID: 2264725902 Enrollment ID: I20160719000464 |
| Provider Name | Jennifer Robb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235403296 PECOS PAC ID: 2264680487 Enrollment ID: I20160805000204 |
| Provider Name | Shikhar Agarwal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326212101 PECOS PAC ID: 1759685464 Enrollment ID: I20160815002218 |
| Provider Name | Travis R Taylor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730455379 PECOS PAC ID: 8426351685 Enrollment ID: I20160822000402 |
| Provider Name | Xun Zhong |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1083874366 PECOS PAC ID: 7517147150 Enrollment ID: I20170127000525 |
| Provider Name | Sandeep Khurana |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1558326207 PECOS PAC ID: 5597733089 Enrollment ID: I20170310000098 |
| Provider Name | Jaya Prakash Sugunaraj |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255647673 PECOS PAC ID: 6608019567 Enrollment ID: I20170710001786 |
| Provider Name | Christopher J Whiting |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104168533 PECOS PAC ID: 5496058653 Enrollment ID: I20170712000848 |
| Provider Name | Raghad A Hussein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801147459 PECOS PAC ID: 4789988130 Enrollment ID: I20170712002606 |
| Provider Name | Andrew M Pataki |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225097637 PECOS PAC ID: 7911976204 Enrollment ID: I20170718000238 |
| Provider Name | Germaine C S Lancaster-mar Fan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922426576 PECOS PAC ID: 4385948215 Enrollment ID: I20170724000344 |
| Provider Name | Joseph Charles Alario |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659647204 PECOS PAC ID: 5294030060 Enrollment ID: I20170801003313 |
| Provider Name | Nada El Andary |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053500470 PECOS PAC ID: 5799926127 Enrollment ID: I20170802000500 |
| Provider Name | Anthony S Ragusea |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730248618 PECOS PAC ID: 1557467297 Enrollment ID: I20170817002652 |
| Provider Name | Dimple Tejwani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861668733 PECOS PAC ID: 4284894445 Enrollment ID: I20170905002951 |
| Provider Name | Benjamin M Keyser |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1568773232 PECOS PAC ID: 8729382825 Enrollment ID: I20170913001654 |
| Provider Name | Kevin W Mcnamara |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871908574 PECOS PAC ID: 1254605645 Enrollment ID: I20170925000289 |
| Provider Name | Shalini Khurana |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164467668 PECOS PAC ID: 0749204493 Enrollment ID: I20171018001264 |
| Provider Name | Jessica L Mckee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598057150 PECOS PAC ID: 5597061267 Enrollment ID: I20171103000395 |
| Provider Name | Holly Kifer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649798174 PECOS PAC ID: 0840556007 Enrollment ID: I20171106000205 |
| Provider Name | Benjamin Pollock |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023351285 PECOS PAC ID: 2567764202 Enrollment ID: I20171129001078 |
| Provider Name | Muhammad Bhatti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922448653 PECOS PAC ID: 1456575430 Enrollment ID: I20180522001948 |
| Provider Name | Alexander Scott Weller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295120848 PECOS PAC ID: 6002171030 Enrollment ID: I20180522003117 |
| Provider Name | Brendan James Carry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376836395 PECOS PAC ID: 8022300433 Enrollment ID: I20180531000068 |
| Provider Name | Shaeesta Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366882516 PECOS PAC ID: 1557666443 Enrollment ID: I20180710003346 |
| Provider Name | Nicholas J Julius |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093100521 PECOS PAC ID: 7214218544 Enrollment ID: I20180712001981 |
| Provider Name | Allison C Malley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245658368 PECOS PAC ID: 7911205620 Enrollment ID: I20180718003802 |
| Provider Name | Rouenne Joie Seeley |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881958957 PECOS PAC ID: 3779832969 Enrollment ID: I20180821003705 |
| Provider Name | Anthony Conlin Torres |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639589740 PECOS PAC ID: 2769709286 Enrollment ID: I20180830000522 |
| Provider Name | Nicholas A Ierovante |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629366554 PECOS PAC ID: 7618278144 Enrollment ID: I20180907000113 |
| Provider Name | Benyam D Addissie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619262854 PECOS PAC ID: 2062668882 Enrollment ID: I20180913002545 |
| Provider Name | Khalil Mehdi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376958306 PECOS PAC ID: 9032467188 Enrollment ID: I20181009002085 |
| Provider Name | Brian T Michaluk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417195603 PECOS PAC ID: 5395883136 Enrollment ID: I20181108001688 |
| Provider Name | Emily A Fuller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356870588 PECOS PAC ID: 2860747326 Enrollment ID: I20190122002114 |
| Provider Name | Susan E Dock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194296129 PECOS PAC ID: 5698012003 Enrollment ID: I20190123002699 |
| Provider Name | Chase B Cohron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518449644 PECOS PAC ID: 6800134339 Enrollment ID: I20190208000252 |
| Provider Name | Melissa J Kireski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225507932 PECOS PAC ID: 6406195882 Enrollment ID: I20190301000440 |
| Provider Name | Varun Pulakanti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750700126 PECOS PAC ID: 8325342744 Enrollment ID: I20190523001580 |
| Provider Name | Nathaniel E Eldredge |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881038073 PECOS PAC ID: 8224333661 Enrollment ID: I20190528001161 |
| Provider Name | Matthew A Mercuri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154749596 PECOS PAC ID: 0143568329 Enrollment ID: I20190619000621 |
| Provider Name | Muhammad T A Malik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528487816 PECOS PAC ID: 3971806134 Enrollment ID: I20190624001136 |
| Provider Name | Amy Jo Hall |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1336709195 PECOS PAC ID: 9335476894 Enrollment ID: I20190807001645 |
| Provider Name | Kaitlyn Noel Tyrie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184010878 PECOS PAC ID: 5496023111 Enrollment ID: I20190904001394 |
| Provider Name | Sara Fang-jone West |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700129517 PECOS PAC ID: 8224332465 Enrollment ID: I20191105001862 |
| Provider Name | John Bak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235770702 PECOS PAC ID: 6608200050 Enrollment ID: I20191218002016 |
| Provider Name | Peter Paul Kobilsek |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073597266 PECOS PAC ID: 7315965837 Enrollment ID: I20191219000520 |
| Provider Name | Juliet Lwanga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346587243 PECOS PAC ID: 6204063944 Enrollment ID: I20191220001766 |
| Provider Name | Hersh Mathur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083009682 PECOS PAC ID: 4486958485 Enrollment ID: I20200113001534 |
| Provider Name | Brittany Tremblay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629615752 PECOS PAC ID: 6406282771 Enrollment ID: I20200204002753 |
| Provider Name | Liana Theroux |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639597156 PECOS PAC ID: 8729300033 Enrollment ID: I20200610000509 |
| Provider Name | Dana L Vanino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558625327 PECOS PAC ID: 8820393309 Enrollment ID: I20200618000547 |
| Provider Name | Shannon Satira |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235769423 PECOS PAC ID: 5092137968 Enrollment ID: I20200623000456 |
| Provider Name | Sara J Hawksworth |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073053534 PECOS PAC ID: 3173945656 Enrollment ID: I20200630001384 |
| Provider Name | Peter L Duffy |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548213481 PECOS PAC ID: 7911803242 Enrollment ID: I20200709000151 |
| Provider Name | Mohamed Hassan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770010498 PECOS PAC ID: 1153744776 Enrollment ID: I20200714003515 |
| Provider Name | Peter J Patitsas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770016396 PECOS PAC ID: 9739503517 Enrollment ID: I20200727002365 |
| Provider Name | Saquib A Siddiqi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174948236 PECOS PAC ID: 1759686207 Enrollment ID: I20200728002787 |
| Provider Name | Mitchell R Onken |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427444538 PECOS PAC ID: 9931452331 Enrollment ID: I20200730003089 |
| Provider Name | Jessica Ahlum |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518354091 PECOS PAC ID: 4385981901 Enrollment ID: I20200824001862 |
| Provider Name | Eliza S Reed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598292070 PECOS PAC ID: 5395162101 Enrollment ID: I20200825002294 |
| Provider Name | Jacques Amja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053842310 PECOS PAC ID: 7517232648 Enrollment ID: I20200923001084 |
| Provider Name | Lukasz Chebes |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1689878878 PECOS PAC ID: 5193919363 Enrollment ID: I20201103001141 |
| Provider Name | Akila Venkataraman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164417879 PECOS PAC ID: 9739219882 Enrollment ID: I20201111000456 |
| Provider Name | Juli L Pyle |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1457950560 PECOS PAC ID: 3971914201 Enrollment ID: I20201118000272 |
| Provider Name | John D Thompson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548610025 PECOS PAC ID: 0042502973 Enrollment ID: I20210126000624 |
| Provider Name | Kyle P Connaghan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740635952 PECOS PAC ID: 3274828215 Enrollment ID: I20210216001888 |
| Provider Name | Jenna Lynn Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972193357 PECOS PAC ID: 1052729597 Enrollment ID: I20210421001497 |
| Provider Name | Alyssa Rae Cuchanski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588050967 PECOS PAC ID: 7810293388 Enrollment ID: I20210608001031 |
| Provider Name | Carolina Jordana Vivar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578916268 PECOS PAC ID: 7012202609 Enrollment ID: I20210615000516 |
| Provider Name | Kristopher Pfirman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306233804 PECOS PAC ID: 6709174360 Enrollment ID: I20210624002395 |
| Provider Name | Hanisha R Manickavasagan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437539640 PECOS PAC ID: 8820499577 Enrollment ID: I20210701001366 |
| Provider Name | Osama Mukarram |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316352586 PECOS PAC ID: 9638469356 Enrollment ID: I20210707000083 |
| Provider Name | Heidi Lynette Hagan |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679147334 PECOS PAC ID: 6608278809 Enrollment ID: I20210712000208 |
| Provider Name | Marvin Braun |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134788557 PECOS PAC ID: 4981934759 Enrollment ID: I20210722001605 |
| Provider Name | Stephen Wall |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1801250105 PECOS PAC ID: 5698178002 Enrollment ID: I20210722002938 |
| Provider Name | Liu Liu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1013336304 PECOS PAC ID: 5991929499 Enrollment ID: I20210802001489 |
| Provider Name | Oyesalewa Omolade Meadows |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356865406 PECOS PAC ID: 6406251644 Enrollment ID: I20210825003500 |
| Provider Name | Sydney Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275208886 PECOS PAC ID: 9638575467 Enrollment ID: I20210902001815 |
| Provider Name | Yididia Melaku Bekele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124529474 PECOS PAC ID: 5890006837 Enrollment ID: I20211007003686 |
| Provider Name | Aaron W Feaster |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134565948 PECOS PAC ID: 9638473523 Enrollment ID: I20211027002982 |
| Provider Name | Anthony Paul Lebario |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1326205808 PECOS PAC ID: 8921248022 Enrollment ID: I20211101000995 |
| Provider Name | Jason Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285397430 PECOS PAC ID: 9335538081 Enrollment ID: I20211118000209 |
| Provider Name | Alexander Zubkov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992721658 PECOS PAC ID: 0244260081 Enrollment ID: I20211123000416 |
| Provider Name | Amirhossein Zangiabadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326294562 PECOS PAC ID: 8628233517 Enrollment ID: I20211123001162 |
| Provider Name | Ulises Nobo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487705141 PECOS PAC ID: 0345138749 Enrollment ID: I20211129000929 |
| Provider Name | Ekelechi Nwanju |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225593783 PECOS PAC ID: 1658610548 Enrollment ID: I20220124002510 |
| Provider Name | Jeffrey B Fisk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578503827 PECOS PAC ID: 9830107713 Enrollment ID: I20220127001603 |
| Provider Name | Harun Otieno |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1336188721 PECOS PAC ID: 6305948381 Enrollment ID: I20220331000005 |
| Provider Name | Jennifer Lynn Simpson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649928813 PECOS PAC ID: 8022404466 Enrollment ID: I20220411002707 |
| Provider Name | Rodrick E. Thomas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952817371 PECOS PAC ID: 5698153997 Enrollment ID: I20220526003061 |
| Provider Name | Michael J Briskey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871081299 PECOS PAC ID: 2163825266 Enrollment ID: I20220602002480 |
| Provider Name | Deidra Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033585286 PECOS PAC ID: 7618260647 Enrollment ID: I20220616001421 |
| Provider Name | Ciana Marie Rollman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376281352 PECOS PAC ID: 1557740784 Enrollment ID: I20220620000009 |
| Provider Name | Ian Coote |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104386184 PECOS PAC ID: 6002296399 Enrollment ID: I20220705000484 |
| Provider Name | Elise Marie Slaughter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568194801 PECOS PAC ID: 0840672382 Enrollment ID: I20220801001624 |
| Provider Name | Melanie J Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073974242 PECOS PAC ID: 4183911027 Enrollment ID: I20220827000120 |
| Provider Name | Sunny Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780045906 PECOS PAC ID: 0648568857 Enrollment ID: I20220916002717 |
| Provider Name | Michelle Lynn Herman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427763382 PECOS PAC ID: 3173996964 Enrollment ID: I20230224002600 |
| Provider Name | Nagib Chowdhury |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184851792 PECOS PAC ID: 8325281207 Enrollment ID: I20230321000251 |
| Provider Name | Naila Shereen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417302290 PECOS PAC ID: 1850757295 Enrollment ID: I20230510000451 |
| Provider Name | Vinodh T Doss |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336348085 PECOS PAC ID: 5698930683 Enrollment ID: I20230511000431 |
| Provider Name | Kenneth A Lowe |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720554389 PECOS PAC ID: 4587903877 Enrollment ID: I20230519000938 |
| Provider Name | Brenda Alexander O Neil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467905778 PECOS PAC ID: 1658651260 Enrollment ID: I20230621000099 |
| Provider Name | Jacqueline M Braden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184866980 PECOS PAC ID: 0042539231 Enrollment ID: I20230727003385 |
| Provider Name | Stephen J Biggiani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770078669 PECOS PAC ID: 1153729363 Enrollment ID: I20230727004109 |
| Provider Name | April N Wright |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184942369 PECOS PAC ID: 2163735499 Enrollment ID: I20230823004508 |
| Provider Name | Cory Joseph Myers |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891228672 PECOS PAC ID: 2062817646 Enrollment ID: I20230830001799 |
| Provider Name | Ruta Yardi Andress |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366852311 PECOS PAC ID: 0941538375 Enrollment ID: I20231020000024 |
| Provider Name | Gwendolyn Mary Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528830478 PECOS PAC ID: 7416306139 Enrollment ID: I20231206004006 |
| Provider Name | Wade J Otruba |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942599840 PECOS PAC ID: 8527374891 Enrollment ID: I20240123003729 |
| Provider Name | Douglas A Valenta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851553879 PECOS PAC ID: 4688728181 Enrollment ID: I20240326002032 |
| Provider Name | Weijun Jin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861812083 PECOS PAC ID: 1557609310 Enrollment ID: I20240401003190 |
| Provider Name | Leonard Dasilva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902873185 PECOS PAC ID: 9830096718 Enrollment ID: I20240403004287 |
| Provider Name | Davida Y Goltz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053725044 PECOS PAC ID: 8729324082 Enrollment ID: I20240405000023 |
| Provider Name | Steve M Cordina |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972777290 PECOS PAC ID: 6002084498 Enrollment ID: I20240412003698 |
| Provider Name | Sebina Bulic |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831326750 PECOS PAC ID: 9931407848 Enrollment ID: I20240416001710 |
| Provider Name | Abdullah Ibish |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154783397 PECOS PAC ID: 0749610582 Enrollment ID: I20240418002060 |
| Provider Name | Gary H Belt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699707422 PECOS PAC ID: 5890810550 Enrollment ID: I20240422000341 |
| Provider Name | Matthew M Higgins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407586571 PECOS PAC ID: 7719326925 Enrollment ID: I20240422001137 |
| Provider Name | Douglas C Westveer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245281674 PECOS PAC ID: 7214849603 Enrollment ID: I20240502003998 |
| Provider Name | Jordan Y Amar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407340409 PECOS PAC ID: 2466832019 Enrollment ID: I20240522000483 |
Ashland Medical Group Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1704 Jefferson Ave, Lewisburg, PA 17837 Phone: 610-709-4173 | |
Student Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Moore Ave, Lewisburg, PA 17837 Phone: 570-577-1401 | |
Geisinger Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 Jpm Rd, Lewisburg, PA 17837 Phone: 570-271-5555 | |
Evangelical-geisinger Health, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Dent Dr, Lewisburg, PA 17837 Phone: 570-577-1401 Fax: 570-577-3570 | |
Ideal Pediatric And Adolescent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 121 Jpm Rd, Lewisburg, PA 17837 Phone: 570-551-0300 | |
Shook Consulting Co. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 Reitz Blvd Ste 1-d, Lewisburg, PA 17837 Phone: 570-701-7212 | |
Geisinger Optometry Lewisburg Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1717 W Market St, Lewisburg, PA 17837 Phone: 570-523-9793 Fax: 570-523-1466 |