| Erie County Medical Center Corporation | |
|
462 Grider St Buffalo NY 14215-3098 | |
| (716) 898-3000 | |
| (716) 898-5178 |
| Full Name | Erie County Medical Center Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 462 Grider St, Buffalo, New York |
| Authorized Official Name and Position | Jonathan Swiatkowski (CFO) |
| Authorized Official Contact | 7168986291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Erie County Medical Center Corporation 820 Us Route 9 Northway Plaza Suite 4f Queensbury NY 12804-1766 Ph: () - | Erie County Medical Center Corporation 462 Grider St Buffalo NY 14215-3098 Ph: (716) 898-3000 |
| NPI Number | 1528233616 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 11/07/2024 |
| Medicare PECOS PAC ID | 1456308907 |
|---|---|
| Medicare Enrollment ID | O20050715000538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528233616 | NPI | - | NPPES |
| 03045416 | Medicaid | NY | |
| DD5582 | Other | NY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | John M Roehmholdt |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801886965 PECOS PAC ID: 3971491861 Enrollment ID: I20040310001197 |
| Provider Name | Darren Alicandri |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1285864637 PECOS PAC ID: 6002707171 Enrollment ID: I20040320000505 |
| Provider Name | Jenny Romero |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1245217553 PECOS PAC ID: 9335133453 Enrollment ID: I20040412001616 |
| Provider Name | Evelyn M Coggins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053387944 PECOS PAC ID: 7719972553 Enrollment ID: I20040420000123 |
| Provider Name | Animesh Sinha |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1285733014 PECOS PAC ID: 4880681857 Enrollment ID: I20040429001579 |
| Provider Name | Joseph M Anain |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215958830 PECOS PAC ID: 0547258972 Enrollment ID: I20040504001496 |
| Provider Name | Christopher A Michaeles |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225060684 PECOS PAC ID: 0244229839 Enrollment ID: I20040510000271 |
| Provider Name | Michael P Butler |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710908348 PECOS PAC ID: 9739179953 Enrollment ID: I20040518000395 |
| Provider Name | Vijay S Iyer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114947272 PECOS PAC ID: 7012998545 Enrollment ID: I20040528000980 |
| Provider Name | Mary Chima |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023144524 PECOS PAC ID: 8628050689 Enrollment ID: I20040603000342 |
| Provider Name | Juliet M Marczak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710960836 PECOS PAC ID: 6103800784 Enrollment ID: I20040614000758 |
| Provider Name | Scott D Klenk |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295821924 PECOS PAC ID: 7416932231 Enrollment ID: I20040623001613 |
| Provider Name | William J Belles |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1346275286 PECOS PAC ID: 5496731481 Enrollment ID: I20040629001004 |
| Provider Name | Mohammad A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033183231 PECOS PAC ID: 1153308176 Enrollment ID: I20040707000517 |
| Provider Name | Sushama Kotmire Thandla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003897414 PECOS PAC ID: 1658350590 Enrollment ID: I20040715000384 |
| Provider Name | Joseph P Falcone |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366449332 PECOS PAC ID: 7113907528 Enrollment ID: I20040724000167 |
| Provider Name | Ravi K Desai |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407810948 PECOS PAC ID: 2466423603 Enrollment ID: I20040803000286 |
| Provider Name | Christopher A Ritter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093788432 PECOS PAC ID: 6608849930 Enrollment ID: I20040816000854 |
| Provider Name | James K Lukan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1023039658 PECOS PAC ID: 4880669092 Enrollment ID: I20040831001241 |
| Provider Name | Farid Berenji |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1699783324 PECOS PAC ID: 2769458272 Enrollment ID: I20040907000752 |
| Provider Name | Michael R Cummings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548278393 PECOS PAC ID: 9830168756 Enrollment ID: I20040928000727 |
| Provider Name | Ellen P Rich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366418345 PECOS PAC ID: 1153382379 Enrollment ID: I20041021000423 |
| Provider Name | Timothy Mcdaniel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144334780 PECOS PAC ID: 9638127368 Enrollment ID: I20050110000120 |
| Provider Name | George Neiderman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346328713 PECOS PAC ID: 9739137274 Enrollment ID: I20050111000523 |
| Provider Name | Robert J Smolinski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619949963 PECOS PAC ID: 1951350529 Enrollment ID: I20050127000351 |
| Provider Name | Jeffrey W Berndtson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457340689 PECOS PAC ID: 1456300029 Enrollment ID: I20050127000399 |
| Provider Name | Mark J Anders |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871559625 PECOS PAC ID: 5890746754 Enrollment ID: I20050208000707 |
| Provider Name | Richard E Ferguson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467420638 PECOS PAC ID: 2860447950 Enrollment ID: I20050322000650 |
| Provider Name | Jai G Wadhwani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124054671 PECOS PAC ID: 8123067055 Enrollment ID: I20050429000013 |
| Provider Name | Antonia J Redhead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740224641 PECOS PAC ID: 5092756593 Enrollment ID: I20050516000093 |
| Provider Name | Mohammad Reza Samie |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356342083 PECOS PAC ID: 6305887845 Enrollment ID: I20050516000429 |
| Provider Name | Rabie N Stephan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417925512 PECOS PAC ID: 9830133347 Enrollment ID: I20050615000838 |
| Provider Name | Howard E Sperry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235169848 PECOS PAC ID: 9032154745 Enrollment ID: I20050623000074 |
| Provider Name | Joseph M Kowalski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043285786 PECOS PAC ID: 0941237184 Enrollment ID: I20050720000202 |
| Provider Name | Bernhard J Rohrbacher |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124090006 PECOS PAC ID: 3971530957 Enrollment ID: I20050721000118 |
| Provider Name | Philip M Stegemann |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467423228 PECOS PAC ID: 1153358130 Enrollment ID: I20050721000129 |
| Provider Name | Nasir Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669411120 PECOS PAC ID: 8224065206 Enrollment ID: I20050721000145 |
| Provider Name | Frederick Michael Elliott |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1023080728 PECOS PAC ID: 8224066451 Enrollment ID: I20050729000376 |
| Provider Name | John M Improta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124182431 PECOS PAC ID: 5092744904 Enrollment ID: I20050811000223 |
| Provider Name | Elisabeth F Mashinic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376682989 PECOS PAC ID: 7113957317 Enrollment ID: I20050817000659 |
| Provider Name | Jan M Novak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427096239 PECOS PAC ID: 3072543164 Enrollment ID: I20050818000265 |
| Provider Name | Larisa Meras |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962474262 PECOS PAC ID: 0446146724 Enrollment ID: I20050819000190 |
| Provider Name | William J Flynn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578586293 PECOS PAC ID: 2961490578 Enrollment ID: I20050822000042 |
| Provider Name | David A Milling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114027430 PECOS PAC ID: 6204720964 Enrollment ID: I20050822000192 |
| Provider Name | Rita Sawyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922094549 PECOS PAC ID: 6204869209 Enrollment ID: I20050913000434 |
| Provider Name | Shirley Chang |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1720063753 PECOS PAC ID: 8921031329 Enrollment ID: I20050915000990 |
| Provider Name | Terrence R Mclean |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1275524316 PECOS PAC ID: 3971538091 Enrollment ID: I20050928000252 |
| Provider Name | Amrit P Singh |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1932127693 PECOS PAC ID: 7315912250 Enrollment ID: I20051011000104 |
| Provider Name | Kathleen T Grimm |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1396709499 PECOS PAC ID: 4385660307 Enrollment ID: I20051019000749 |
| Provider Name | Hong Yu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285760819 PECOS PAC ID: 1658341540 Enrollment ID: I20051025000461 |
| Provider Name | Jennifer L Haak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205925039 PECOS PAC ID: 5597784934 Enrollment ID: I20051115000950 |
| Provider Name | Audrey A Hoerner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831256494 PECOS PAC ID: 2961421243 Enrollment ID: I20051116000178 |
| Provider Name | Paula Delregno |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821064718 PECOS PAC ID: 4486660958 Enrollment ID: I20060222000095 |
| Provider Name | Vladan M Radovic |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780664441 PECOS PAC ID: 7214944115 Enrollment ID: I20060317000450 |
| Provider Name | Mark A Livecchi |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043205545 PECOS PAC ID: 5496763971 Enrollment ID: I20060324000573 |
| Provider Name | Saurin R Popat |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1073569877 PECOS PAC ID: 1951311232 Enrollment ID: I20060504000018 |
| Provider Name | Mandip Panesar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1164471959 PECOS PAC ID: 1456363928 Enrollment ID: I20060629000113 |
| Provider Name | Regina Makdissi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487662292 PECOS PAC ID: 2264435734 Enrollment ID: I20060823000269 |
| Provider Name | Victoria L Brooks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578590022 PECOS PAC ID: 5092719641 Enrollment ID: I20060913000110 |
| Provider Name | Dori R Marshall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659301026 PECOS PAC ID: 4587669742 Enrollment ID: I20060921000131 |
| Provider Name | Weidun A Guo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598779720 PECOS PAC ID: 1759388549 Enrollment ID: I20061109000301 |
| Provider Name | John R Fudyma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073562716 PECOS PAC ID: 6103873542 Enrollment ID: I20061208000192 |
| Provider Name | Jack P Freer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154393015 PECOS PAC ID: 8224038492 Enrollment ID: I20070111000510 |
| Provider Name | Thomas Mahl |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780633412 PECOS PAC ID: 2961396619 Enrollment ID: I20070321000427 |
| Provider Name | Mary R Welch |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1891796512 PECOS PAC ID: 2466556998 Enrollment ID: I20070322000409 |
| Provider Name | Susan A Gunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427070663 PECOS PAC ID: 0143222307 Enrollment ID: I20070328000021 |
| Provider Name | Christopher Schaeffer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265404982 PECOS PAC ID: 2668577974 Enrollment ID: I20070416000286 |
| Provider Name | Richard N Gilbert |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336146984 PECOS PAC ID: 2567452683 Enrollment ID: I20070614000634 |
| Provider Name | Robert F Glover |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164466298 PECOS PAC ID: 3779472097 Enrollment ID: I20070702000523 |
| Provider Name | Joanne L Mcvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558344564 PECOS PAC ID: 7911007687 Enrollment ID: I20070710000729 |
| Provider Name | Eileen B Purcell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831242973 PECOS PAC ID: 5395836621 Enrollment ID: I20070801000162 |
| Provider Name | Corazon Nicanor Hoffman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730124322 PECOS PAC ID: 3870588015 Enrollment ID: I20070817000664 |
| Provider Name | Isabel K Komornicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609801927 PECOS PAC ID: 8921192279 Enrollment ID: I20070918000585 |
| Provider Name | Michael A Rauh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205985645 PECOS PAC ID: 6305931908 Enrollment ID: I20070927000371 |
| Provider Name | Geoffrey Bernas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780757641 PECOS PAC ID: 7517069818 Enrollment ID: I20071121000063 |
| Provider Name | Robert C Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679777676 PECOS PAC ID: 9931298940 Enrollment ID: I20071128000682 |
| Provider Name | Carly A Gerretsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871783134 PECOS PAC ID: 5890884332 Enrollment ID: I20071205000462 |
| Provider Name | Lynn M Kordasiewicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124213780 PECOS PAC ID: 4789774712 Enrollment ID: I20071214000251 |
| Provider Name | Lisa Marie Kalinka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821136342 PECOS PAC ID: 8921198623 Enrollment ID: I20071219000096 |
| Provider Name | Jennifer A Turesky |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1265591721 PECOS PAC ID: 4587744628 Enrollment ID: I20080102000464 |
| Provider Name | Fred J Rodems |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1497799647 PECOS PAC ID: 5193806610 Enrollment ID: I20080122000559 |
| Provider Name | Christopher E Mutty |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295934446 PECOS PAC ID: 0648356576 Enrollment ID: I20080716000216 |
| Provider Name | Yogesh D Bakhai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649246521 PECOS PAC ID: 0446159131 Enrollment ID: I20081027000685 |
| Provider Name | Tomi E Shisler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417979782 PECOS PAC ID: 4688721095 Enrollment ID: I20090421000630 |
| Provider Name | Edward Ventresca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154395648 PECOS PAC ID: 9931164506 Enrollment ID: I20090616000012 |
| Provider Name | Ranjit Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194718486 PECOS PAC ID: 3173674397 Enrollment ID: I20090630000236 |
| Provider Name | Michael T Guppenberger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912169681 PECOS PAC ID: 2769536788 Enrollment ID: I20090811000016 |
| Provider Name | Aimee Stanislawski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376657189 PECOS PAC ID: 4981672987 Enrollment ID: I20090825000111 |
| Provider Name | Faye E Justicia Linde |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821110263 PECOS PAC ID: 8426104563 Enrollment ID: I20090915000560 |
| Provider Name | Joseph M Rasnick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881887537 PECOS PAC ID: 3870649270 Enrollment ID: I20090930000389 |
| Provider Name | Rachael A Rossitto |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1184605362 PECOS PAC ID: 0244373934 Enrollment ID: I20100203000352 |
| Provider Name | David Holmes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780678409 PECOS PAC ID: 4688709207 Enrollment ID: I20100320000080 |
| Provider Name | Joseph Greco |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487650016 PECOS PAC ID: 1951395946 Enrollment ID: I20100323000774 |
| Provider Name | Raphael J Leo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063488062 PECOS PAC ID: 7012043102 Enrollment ID: I20100329000036 |
| Provider Name | Paul I Tomljanovich |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053392829 PECOS PAC ID: 3779612270 Enrollment ID: I20100521000113 |
| Provider Name | Maureen A Sullivan Nasca |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1114908985 PECOS PAC ID: 4880723279 Enrollment ID: I20100524000281 |
| Provider Name | Robert F Reed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841264215 PECOS PAC ID: 8224167333 Enrollment ID: I20100528000231 |
| Provider Name | Arthur E Orlick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639143456 PECOS PAC ID: 9537178405 Enrollment ID: I20100609000005 |
| Provider Name | Kent K Chevli |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215934781 PECOS PAC ID: 5294725305 Enrollment ID: I20100618000339 |
| Provider Name | Thom R Loree |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1215927330 PECOS PAC ID: 5496886079 Enrollment ID: I20100625000345 |
| Provider Name | Christopher J Skomra |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1841297496 PECOS PAC ID: 7911997036 Enrollment ID: I20100701000103 |
| Provider Name | Jeffrey J Brewer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508930363 PECOS PAC ID: 7810092137 Enrollment ID: I20100707000336 |
| Provider Name | Thomas R Duquin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093960023 PECOS PAC ID: 1951457704 Enrollment ID: I20100716000632 |
| Provider Name | Chukwumere E Nwogu |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1164403770 PECOS PAC ID: 6002948122 Enrollment ID: I20100724000037 |
| Provider Name | Mary Carol C Scrocco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437474715 PECOS PAC ID: 9133252679 Enrollment ID: I20100804000165 |
| Provider Name | Michael Stephen Chopko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093970592 PECOS PAC ID: 6901930882 Enrollment ID: I20100813000485 |
| Provider Name | Mark S Burke |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1730341074 PECOS PAC ID: 7911022397 Enrollment ID: I20100909000593 |
| Provider Name | Cynthia A Pristach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821036625 PECOS PAC ID: 4284827213 Enrollment ID: I20101021001227 |
| Provider Name | Raphael Blochle |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1891958138 PECOS PAC ID: 1456545854 Enrollment ID: I20101029000822 |
| Provider Name | James K Farry |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1174652044 PECOS PAC ID: 2365638301 Enrollment ID: I20101202000131 |
| Provider Name | Liveleen M Gill |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1427042647 PECOS PAC ID: 0042407587 Enrollment ID: I20101209000197 |
| Provider Name | Gregory J Castiglia |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1003891896 PECOS PAC ID: 4486703535 Enrollment ID: I20101220000190 |
| Provider Name | Mark D Chazen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1518931989 PECOS PAC ID: 4284823758 Enrollment ID: I20110114000011 |
| Provider Name | John V Pinski |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316911779 PECOS PAC ID: 8123085362 Enrollment ID: I20110504000015 |
| Provider Name | Brian D Rambarran |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235391244 PECOS PAC ID: 1254518699 Enrollment ID: I20110610000555 |
| Provider Name | Richard E Hall |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1871606376 PECOS PAC ID: 0345410700 Enrollment ID: I20110823000698 |
| Provider Name | Victor J Vacanti |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558522268 PECOS PAC ID: 6002086287 Enrollment ID: I20110825000286 |
| Provider Name | Haider A Khadim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174788541 PECOS PAC ID: 2163692351 Enrollment ID: I20110825000439 |
| Provider Name | Liise K Kayler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093789562 PECOS PAC ID: 3971532177 Enrollment ID: I20111012000330 |
| Provider Name | Balwant S Nagra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639354848 PECOS PAC ID: 8820260946 Enrollment ID: I20111017000046 |
| Provider Name | Anne C Banas |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1255650842 PECOS PAC ID: 8820262561 Enrollment ID: I20111115000795 |
| Provider Name | Henry E Reyes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144456880 PECOS PAC ID: 8729255526 Enrollment ID: I20120119000289 |
| Provider Name | Nalini B Packianathan |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1750653101 PECOS PAC ID: 1355501958 Enrollment ID: I20120319000511 |
| Provider Name | Vinayak S Gokhale |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508832403 PECOS PAC ID: 1153582960 Enrollment ID: I20120420000510 |
| Provider Name | John Joseph Bodkin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1144464942 PECOS PAC ID: 8527221779 Enrollment ID: I20120525000193 |
| Provider Name | John M Rutkowski |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902061914 PECOS PAC ID: 9032388566 Enrollment ID: I20120530000005 |
| Provider Name | Biswarup Manojkumar Ghosh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730333857 PECOS PAC ID: 9436313715 Enrollment ID: I20120618000502 |
| Provider Name | Amit Kandel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174899504 PECOS PAC ID: 1254595531 Enrollment ID: I20120618000504 |
| Provider Name | Stacey N Akers |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1639204829 PECOS PAC ID: 9830281252 Enrollment ID: I20120813000249 |
| Provider Name | Michael S Adragna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801020581 PECOS PAC ID: 0941457972 Enrollment ID: I20120828000019 |
| Provider Name | Nicholas J Violante |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215193800 PECOS PAC ID: 0345418976 Enrollment ID: I20120913000578 |
| Provider Name | Annemarie L Mikowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336383041 PECOS PAC ID: 0749430437 Enrollment ID: I20121015000232 |
| Provider Name | Julie Fasanello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225393689 PECOS PAC ID: 3577715333 Enrollment ID: I20121201000045 |
| Provider Name | Devinalini Misir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073713251 PECOS PAC ID: 0042462228 Enrollment ID: I20121215000036 |
| Provider Name | Christine M Klemp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558617803 PECOS PAC ID: 1456503630 Enrollment ID: I20121217000038 |
| Provider Name | Jad Z Bou Abdallah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619133436 PECOS PAC ID: 9133373954 Enrollment ID: I20130202000033 |
| Provider Name | Brianna J Haws |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962755363 PECOS PAC ID: 0648425116 Enrollment ID: I20130307000158 |
| Provider Name | Anthony D Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598712754 PECOS PAC ID: 7315007242 Enrollment ID: I20130309000094 |
| Provider Name | David J Diina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063776953 PECOS PAC ID: 5395984538 Enrollment ID: I20130618000822 |
| Provider Name | Stacey Forgensi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063758134 PECOS PAC ID: 2567604978 Enrollment ID: I20130815000002 |
| Provider Name | Christopher M Resetarits |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477899193 PECOS PAC ID: 9032343553 Enrollment ID: I20131016000076 |
| Provider Name | Tova S Ablove |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497714968 PECOS PAC ID: 7113912692 Enrollment ID: I20131024001664 |
| Provider Name | Zhanna A Elberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326209032 PECOS PAC ID: 1557597325 Enrollment ID: I20131127000067 |
| Provider Name | Jennifer Frustino |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1710116496 PECOS PAC ID: 5698913762 Enrollment ID: I20140225000603 |
| Provider Name | Kathryn C Korff |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1669766846 PECOS PAC ID: 1850521329 Enrollment ID: I20140228001105 |
| Provider Name | Joan Canzoneri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740455690 PECOS PAC ID: 6800029463 Enrollment ID: I20140506000696 |
| Provider Name | Jorge A Ortiz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154388809 PECOS PAC ID: 5193790095 Enrollment ID: I20140520000144 |
| Provider Name | Matthew L Ruggieri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639304785 PECOS PAC ID: 9032336615 Enrollment ID: I20140805001089 |
| Provider Name | Joshna Md Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922313113 PECOS PAC ID: 7810115656 Enrollment ID: I20140820001282 |
| Provider Name | Amanda C Colebeck |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1770922783 PECOS PAC ID: 1850519588 Enrollment ID: I20140821001734 |
| Provider Name | Jeffrey Michael Jordan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558504738 PECOS PAC ID: 8820216237 Enrollment ID: I20140827000776 |
| Provider Name | Shaveta Malik |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154632966 PECOS PAC ID: 8426276601 Enrollment ID: I20140829001740 |
| Provider Name | Clairice Ann Cooper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134362478 PECOS PAC ID: 4082834387 Enrollment ID: I20141009000743 |
| Provider Name | Marcella Zynda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083900054 PECOS PAC ID: 4082834130 Enrollment ID: I20141013001602 |
| Provider Name | Jonathan A Claus |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1184852113 PECOS PAC ID: 9436375748 Enrollment ID: I20141017001375 |
| Provider Name | Herbert Duvivier |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1710982731 PECOS PAC ID: 6800889742 Enrollment ID: I20141120000614 |
| Provider Name | Michelle Boyd Augello |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043526437 PECOS PAC ID: 4183940182 Enrollment ID: I20150311000288 |
| Provider Name | Dana Tague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376940429 PECOS PAC ID: 6709102502 Enrollment ID: I20150312001908 |
| Provider Name | Beata V Dobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699161265 PECOS PAC ID: 9537471651 Enrollment ID: I20150702000887 |
| Provider Name | Katherine E Flower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821360330 PECOS PAC ID: 3173835162 Enrollment ID: I20150706000534 |
| Provider Name | Marc J Siebert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932536240 PECOS PAC ID: 3577879204 Enrollment ID: I20150826001042 |
| Provider Name | Anuradha Mendu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104183144 PECOS PAC ID: 6002123775 Enrollment ID: I20150911001926 |
| Provider Name | Naheed Alam |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1255592168 PECOS PAC ID: 8224347323 Enrollment ID: I20151012000514 |
| Provider Name | Elizabeth Barbara Kapral |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841635489 PECOS PAC ID: 7517268840 Enrollment ID: I20151210001911 |
| Provider Name | Christina Sanders |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811142532 PECOS PAC ID: 7214171982 Enrollment ID: I20151211000571 |
| Provider Name | Parveen K Minhas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366818528 PECOS PAC ID: 5597068130 Enrollment ID: I20160114002345 |
| Provider Name | Patrick Glasgow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629358379 PECOS PAC ID: 4587960679 Enrollment ID: I20160316001006 |
| Provider Name | Robert L Glover |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164712378 PECOS PAC ID: 0941599377 Enrollment ID: I20160525000591 |
| Provider Name | Angela Marie Riznyk-bosworth |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1679912349 PECOS PAC ID: 3274824560 Enrollment ID: I20160616000672 |
| Provider Name | Elizabeth A Zynda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861871121 PECOS PAC ID: 6507158672 Enrollment ID: I20160711000853 |
| Provider Name | Michael Y Nagai |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1952621666 PECOS PAC ID: 5597050310 Enrollment ID: I20160818000771 |
| Provider Name | Laura Hanrahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437419165 PECOS PAC ID: 9739475211 Enrollment ID: I20160909000143 |
| Provider Name | Peter A Davidow |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1801206438 PECOS PAC ID: 0345538898 Enrollment ID: I20161017000247 |
| Provider Name | Nicole K Bonito |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457806820 PECOS PAC ID: 4183902232 Enrollment ID: I20161025002147 |
| Provider Name | Evgeny A Dyskin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093958704 PECOS PAC ID: 7618288929 Enrollment ID: I20161111000214 |
| Provider Name | Hannah R Lapides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184172223 PECOS PAC ID: 7214216241 Enrollment ID: I20161116000302 |
| Provider Name | Tawni A Frank |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366450736 PECOS PAC ID: 1850337239 Enrollment ID: I20161130001958 |
| Provider Name | Anne Grand'maison |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1699170803 PECOS PAC ID: 5294015582 Enrollment ID: I20161202000329 |
| Provider Name | Mary Jo Kish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184074288 PECOS PAC ID: 0941580765 Enrollment ID: I20161213000295 |
| Provider Name | Hema D Dodd |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811285240 PECOS PAC ID: 9133401557 Enrollment ID: I20170119002457 |
| Provider Name | Brandon Brownell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861837361 PECOS PAC ID: 8325322407 Enrollment ID: I20170309001497 |
| Provider Name | Michael R Markiewicz |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1225291347 PECOS PAC ID: 6507011152 Enrollment ID: I20170427000112 |
| Provider Name | Sarah A Abdelsayed |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1093065138 PECOS PAC ID: 9032346622 Enrollment ID: I20170530000533 |
| Provider Name | Joseph D. Mills |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396027207 PECOS PAC ID: 4880965078 Enrollment ID: I20170807001641 |
| Provider Name | John B Ortolani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760781330 PECOS PAC ID: 3577797489 Enrollment ID: I20170824000679 |
| Provider Name | Liam T Knott |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245593219 PECOS PAC ID: 5496052961 Enrollment ID: I20170829000173 |
| Provider Name | Matthew W Hodgson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659809762 PECOS PAC ID: 6103190509 Enrollment ID: I20170925000566 |
| Provider Name | Jennifer Murtha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770009946 PECOS PAC ID: 7012283278 Enrollment ID: I20171017000430 |
| Provider Name | Eleanor C Fung |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780078394 PECOS PAC ID: 4981911484 Enrollment ID: I20171107002651 |
| Provider Name | Lucas J Speak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750890919 PECOS PAC ID: 8022375807 Enrollment ID: I20171204000776 |
| Provider Name | Kulwant K Buttar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366486789 PECOS PAC ID: 3870597628 Enrollment ID: I20171222000566 |
| Provider Name | William E Boggiano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609110113 PECOS PAC ID: 6204159338 Enrollment ID: I20180326002739 |
| Provider Name | Rebecca Hicks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750725610 PECOS PAC ID: 0648533323 Enrollment ID: I20180410002774 |
| Provider Name | Carmen L Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760913503 PECOS PAC ID: 4486917135 Enrollment ID: I20180411002695 |
| Provider Name | Tildabeth Doscher |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1700906823 PECOS PAC ID: 5092095265 Enrollment ID: I20180412001485 |
| Provider Name | Christopher J Hughes |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1265948335 PECOS PAC ID: 4183987779 Enrollment ID: I20180412001741 |
| Provider Name | Jessica Bortel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780028621 PECOS PAC ID: 6406119973 Enrollment ID: I20180416000502 |
| Provider Name | Susan Mae Daoust |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104050426 PECOS PAC ID: 9335455856 Enrollment ID: I20180420000946 |
| Provider Name | Jenine M Paner-bansi |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1316383672 PECOS PAC ID: 2769778414 Enrollment ID: I20180420001356 |
| Provider Name | Jon R Vonvisger |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518974864 PECOS PAC ID: 9133164585 Enrollment ID: I20180614001088 |
| Provider Name | Ahmad A Zaaroura |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073945432 PECOS PAC ID: 7113154196 Enrollment ID: I20180710000049 |
| Provider Name | Matthew Thomas Binkley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922307214 PECOS PAC ID: 1951697507 Enrollment ID: I20180718002997 |
| Provider Name | Sikandar Z Khan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1114219284 PECOS PAC ID: 1759638778 Enrollment ID: I20180723002225 |
| Provider Name | Thomas C Suchy |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1477999456 PECOS PAC ID: 8123377629 Enrollment ID: I20180816001382 |
| Provider Name | Dennis M Jack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659858827 PECOS PAC ID: 3678822939 Enrollment ID: I20180820001666 |
| Provider Name | Paul Canallatos |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841551652 PECOS PAC ID: 2466758461 Enrollment ID: I20180821002306 |
| Provider Name | Jessica Canallatos |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1326492208 PECOS PAC ID: 8820397649 Enrollment ID: I20180822000360 |
| Provider Name | Robert W Macek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306231329 PECOS PAC ID: 5890044713 Enrollment ID: I20180824002332 |
| Provider Name | Ju Joh |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1750737110 PECOS PAC ID: 2062756018 Enrollment ID: I20181203002470 |
| Provider Name | Rachel Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700379799 PECOS PAC ID: 3274878772 Enrollment ID: I20190102001125 |
| Provider Name | Sarah Gibbons |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841548245 PECOS PAC ID: 7911244546 Enrollment ID: I20190121000901 |
| Provider Name | Richard C Chou |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1811915911 PECOS PAC ID: 7315940947 Enrollment ID: I20190308001260 |
| Provider Name | Brenna E Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801300017 PECOS PAC ID: 4284974189 Enrollment ID: I20190312002455 |
| Provider Name | Mahfuz Oumer Yonis |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1164675898 PECOS PAC ID: 7618196023 Enrollment ID: I20190326003069 |
| Provider Name | Amy L Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750888020 PECOS PAC ID: 1557602877 Enrollment ID: I20190412002061 |
| Provider Name | Joshua E Meyers |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1619230505 PECOS PAC ID: 4688912249 Enrollment ID: I20190418000663 |
| Provider Name | Robert P Pszonak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417085424 PECOS PAC ID: 7315246709 Enrollment ID: I20190506002506 |
| Provider Name | Suzanne C Griffith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063675676 PECOS PAC ID: 7315134681 Enrollment ID: I20190624001310 |
| Provider Name | Melissa M Hovak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851853980 PECOS PAC ID: 1658605787 Enrollment ID: I20190624003289 |
| Provider Name | Jeffrey Spencer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861802373 PECOS PAC ID: 0446596258 Enrollment ID: I20190702001289 |
| Provider Name | Vaqar H Shah |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1356750350 PECOS PAC ID: 3375855216 Enrollment ID: I20190708000225 |
| Provider Name | Rachelle M St Onge |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154709046 PECOS PAC ID: 0941545925 Enrollment ID: I20190722002472 |
| Provider Name | Alysia V Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1639599848 PECOS PAC ID: 4486922408 Enrollment ID: I20190731000502 |
| Provider Name | Zachary G Puca |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174919161 PECOS PAC ID: 6800133984 Enrollment ID: I20190819002302 |
| Provider Name | Jean V Aiad |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1285167585 PECOS PAC ID: 5193053882 Enrollment ID: I20190819003584 |
| Provider Name | Richard Marc Spiro |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1790753622 PECOS PAC ID: 1557251154 Enrollment ID: I20190823002054 |
| Provider Name | Amanda Kosior |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518510502 PECOS PAC ID: 2163750175 Enrollment ID: I20190828001565 |
| Provider Name | Courtney J Peterson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1649658691 PECOS PAC ID: 3870821879 Enrollment ID: I20190829001583 |
| Provider Name | Nicole C Piscatelli |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1669908752 PECOS PAC ID: 8527396423 Enrollment ID: I20190829001934 |
| Provider Name | Joseph V Brindisi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902322340 PECOS PAC ID: 9931439452 Enrollment ID: I20190926001508 |
| Provider Name | Yaron Perry |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1508013608 PECOS PAC ID: 0648162875 Enrollment ID: I20191008003887 |
| Provider Name | Holly N Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518518174 PECOS PAC ID: 0143552844 Enrollment ID: I20191030001343 |
| Provider Name | Abigail S Green |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508251497 PECOS PAC ID: 0446582001 Enrollment ID: I20191031000298 |
| Provider Name | Arthur F Weissman |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1194125500 PECOS PAC ID: 7113221763 Enrollment ID: I20191205002546 |
| Provider Name | Brooke Kolber |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1316471287 PECOS PAC ID: 7517390107 Enrollment ID: I20191212002167 |
| Provider Name | Rosh-neke D Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255972386 PECOS PAC ID: 2264866904 Enrollment ID: I20200106000570 |
| Provider Name | Danielle C Balasubramaniam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366072621 PECOS PAC ID: 1658700943 Enrollment ID: I20200408001143 |
| Provider Name | Jordan D Frey |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1376988568 PECOS PAC ID: 7315285574 Enrollment ID: I20200513003100 |
| Provider Name | Kathleen Keely Boyle |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255750675 PECOS PAC ID: 0446597926 Enrollment ID: I20200514001520 |
| Provider Name | Benjamin Levy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427465319 PECOS PAC ID: 9335571512 Enrollment ID: I20200526002688 |
| Provider Name | Bridget M Rippe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922627090 PECOS PAC ID: 0143643726 Enrollment ID: I20200715001164 |
| Provider Name | Charles T Camp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699138057 PECOS PAC ID: 2961749072 Enrollment ID: I20200806003455 |
| Provider Name | Elizabeth Lucaj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861855181 PECOS PAC ID: 3971840042 Enrollment ID: I20200807002027 |
| Provider Name | Ramkishen Narayanan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215296348 PECOS PAC ID: 3375809171 Enrollment ID: I20200817003072 |
| Provider Name | Katelyn E Mazgaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760018287 PECOS PAC ID: 9234555152 Enrollment ID: I20200821001430 |
| Provider Name | Samer Kareem |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1548799190 PECOS PAC ID: 2163849126 Enrollment ID: I20200905000073 |
| Provider Name | Sarah A Sporski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720628613 PECOS PAC ID: 0648698522 Enrollment ID: I20200909000864 |
| Provider Name | Jason T Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124472204 PECOS PAC ID: 9335486778 Enrollment ID: I20201007002328 |
| Provider Name | Kimberly Joanne Wilkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851825442 PECOS PAC ID: 8921345364 Enrollment ID: I20201110002547 |
| Provider Name | Cindy S Yip |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710364443 PECOS PAC ID: 2769727650 Enrollment ID: I20201111001895 |
| Provider Name | Jill N Tirabassi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720345606 PECOS PAC ID: 5890008015 Enrollment ID: I20201113002005 |
| Provider Name | Yi Shun F Cheng |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063808889 PECOS PAC ID: 7315284783 Enrollment ID: I20201120002090 |
| Provider Name | Jaskiran Nagra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437745825 PECOS PAC ID: 2668887761 Enrollment ID: I20210223003317 |
| Provider Name | Michael R Digiacomo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629204375 PECOS PAC ID: 2961829502 Enrollment ID: I20210311001991 |
| Provider Name | Kristina C Baranyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013592864 PECOS PAC ID: 2769890102 Enrollment ID: I20210423000070 |
| Provider Name | Tammas F Kelly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710901418 PECOS PAC ID: 8022175884 Enrollment ID: I20210504001441 |
| Provider Name | David J Abramowitz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1265850390 PECOS PAC ID: 7719309517 Enrollment ID: I20210510001293 |
| Provider Name | Sunghoon Jung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184209686 PECOS PAC ID: 2466851662 Enrollment ID: I20210520000108 |
| Provider Name | Jacquelyn M Gonka-griffo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902292733 PECOS PAC ID: 0749524601 Enrollment ID: I20210611000200 |
| Provider Name | Vincent J Croglio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952835977 PECOS PAC ID: 8123365236 Enrollment ID: I20210621000571 |
| Provider Name | Thamer R Qaqish |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073953006 PECOS PAC ID: 9537398771 Enrollment ID: I20210624002020 |
| Provider Name | Gina Nicole Tundo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003293887 PECOS PAC ID: 0042518235 Enrollment ID: I20210726003151 |
| Provider Name | Gurmat K Gill |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1275987778 PECOS PAC ID: 4688917040 Enrollment ID: I20210730000903 |
| Provider Name | Richard L Raptopoulos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679836985 PECOS PAC ID: 9537318605 Enrollment ID: I20210813000210 |
| Provider Name | Meghan Rose Rochester |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255866109 PECOS PAC ID: 2567730534 Enrollment ID: I20210830001353 |
| Provider Name | Ellen Mcstravick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083220677 PECOS PAC ID: 5092111971 Enrollment ID: I20210831003493 |
| Provider Name | Elana Tal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992183925 PECOS PAC ID: 8325374895 Enrollment ID: I20210902003310 |
| Provider Name | Hui Tung Tony Lin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992292213 PECOS PAC ID: 9739426131 Enrollment ID: I20210910002915 |
| Provider Name | Evelyn Walsh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235519083 PECOS PAC ID: 2668711227 Enrollment ID: I20210927003490 |
| Provider Name | Mayada Ismail |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740663962 PECOS PAC ID: 9436450913 Enrollment ID: I20211021000477 |
| Provider Name | Joanne S Keuck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952971020 PECOS PAC ID: 1759779739 Enrollment ID: I20211025000689 |
| Provider Name | Andrew Stegemann |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043674724 PECOS PAC ID: 2466799077 Enrollment ID: I20211119000028 |
| Provider Name | Shana Ann Mazgaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881356137 PECOS PAC ID: 4183016462 Enrollment ID: I20220118002053 |
| Provider Name | Bradley Carrier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033606736 PECOS PAC ID: 6800133109 Enrollment ID: I20220128001632 |
| Provider Name | Jillian Lee Piniewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720748031 PECOS PAC ID: 1557755154 Enrollment ID: I20220224001734 |
| Provider Name | Calla Marie Humphrey |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477218766 PECOS PAC ID: 4183019102 Enrollment ID: I20220309002126 |
| Provider Name | Ranae Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982344297 PECOS PAC ID: 2769860816 Enrollment ID: I20220602001182 |
| Provider Name | Kearsten Ann Pipkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447918982 PECOS PAC ID: 8123406899 Enrollment ID: I20220608002024 |
| Provider Name | James Farrell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609222421 PECOS PAC ID: 5991041378 Enrollment ID: I20220725002253 |
| Provider Name | Michael E Farrell |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1972811628 PECOS PAC ID: 8426450628 Enrollment ID: I20220727001921 |
| Provider Name | Mark C Sutton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720574056 PECOS PAC ID: 4486036670 Enrollment ID: I20220804001705 |
| Provider Name | Erica Hartmann |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366070138 PECOS PAC ID: 6800279506 Enrollment ID: I20220812001623 |
| Provider Name | Julia A Ringel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730611872 PECOS PAC ID: 9234476508 Enrollment ID: I20220817002320 |
| Provider Name | Robel Kamal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457845448 PECOS PAC ID: 7911242029 Enrollment ID: I20220830002949 |
| Provider Name | Rebeccah L Stevens |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013414549 PECOS PAC ID: 9234476516 Enrollment ID: I20220913001869 |
| Provider Name | Alia N Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184114951 PECOS PAC ID: 0244577336 Enrollment ID: I20220913001958 |
| Provider Name | Mark Hodgson Falco |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1932460664 PECOS PAC ID: 7618379272 Enrollment ID: I20220922003264 |
| Provider Name | Thomas Dobosz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568894772 PECOS PAC ID: 7911203955 Enrollment ID: I20221026002006 |
| Provider Name | Shaily Amin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619409448 PECOS PAC ID: 3870866429 Enrollment ID: I20221026002055 |
| Provider Name | Olivia Ann Wilhelm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871227876 PECOS PAC ID: 9830566421 Enrollment ID: I20221111000355 |
| Provider Name | Demetra Mcilwain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871056002 PECOS PAC ID: 6406183755 Enrollment ID: I20221116002362 |
| Provider Name | Katelyn M Crowley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285197954 PECOS PAC ID: 3577961689 Enrollment ID: I20221128002362 |
| Provider Name | Jessica Bielawa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376278465 PECOS PAC ID: 3274902648 Enrollment ID: I20221206002762 |
| Provider Name | Leigh-anne B Diorio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326715228 PECOS PAC ID: 5799154134 Enrollment ID: I20221207001974 |
| Provider Name | Samantha J Deans |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922492131 PECOS PAC ID: 4981905858 Enrollment ID: I20221220000963 |
| Provider Name | Erin K Ly |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740638725 PECOS PAC ID: 5193052348 Enrollment ID: I20230221000526 |
| Provider Name | Juliane Maciejewski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194814004 PECOS PAC ID: 6709840275 Enrollment ID: I20230221001644 |
| Provider Name | Demetrius Rizos |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063491397 PECOS PAC ID: 0648379180 Enrollment ID: I20230322002725 |
| Provider Name | Clayton Del Prince |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1710411848 PECOS PAC ID: 7416336714 Enrollment ID: I20230328000461 |
| Provider Name | Sreedhar Chamala |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477858819 PECOS PAC ID: 7113383803 Enrollment ID: I20230523001367 |
| Provider Name | Joshua A Nazirbage |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376033217 PECOS PAC ID: 4688911738 Enrollment ID: I20230605001884 |
| Provider Name | Jemma N. Rampersaud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235793399 PECOS PAC ID: 8426387630 Enrollment ID: I20230614002123 |
| Provider Name | Devinderpal Singh Randhawa |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1225072648 PECOS PAC ID: 8325045792 Enrollment ID: I20230615003008 |
| Provider Name | Jenna Marie Walden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336846187 PECOS PAC ID: 5597124263 Enrollment ID: I20230629000735 |
| Provider Name | Kayla Nieswiadomy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285323725 PECOS PAC ID: 3577922103 Enrollment ID: I20230629003021 |
| Provider Name | Logan K Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912535113 PECOS PAC ID: 8820411366 Enrollment ID: I20230703001376 |
| Provider Name | James L Thompson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508429374 PECOS PAC ID: 4284961574 Enrollment ID: I20230705002025 |
| Provider Name | Nicole A Baruch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669975918 PECOS PAC ID: 1456609007 Enrollment ID: I20230706002002 |
| Provider Name | Katie N Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649711714 PECOS PAC ID: 3971962804 Enrollment ID: I20230710002414 |
| Provider Name | Hanna N Algattas |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1235588047 PECOS PAC ID: 6901274711 Enrollment ID: I20230815000060 |
| Provider Name | Nicole Marie Haseley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992497093 PECOS PAC ID: 1355704305 Enrollment ID: I20230824001068 |
| Provider Name | Russell J Pizzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053974436 PECOS PAC ID: 7517294960 Enrollment ID: I20230912000458 |
| Provider Name | Dawid Czarny |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1083101976 PECOS PAC ID: 1557608981 Enrollment ID: I20230927001511 |
| Provider Name | Rahat Whig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104480474 PECOS PAC ID: 6608103957 Enrollment ID: I20231009002081 |
| Provider Name | David Best |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508393414 PECOS PAC ID: 4183967383 Enrollment ID: I20231121001783 |
| Provider Name | Samad Nasaryab Hassan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922415751 PECOS PAC ID: 8426480682 Enrollment ID: I20231205000240 |
| Provider Name | Shafiq Cheema |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083611974 PECOS PAC ID: 8729076732 Enrollment ID: I20231229000416 |
| Provider Name | Joseph Merkel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548722267 PECOS PAC ID: 2961739008 Enrollment ID: I20240405002274 |
| Provider Name | Katherine Beall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689438434 PECOS PAC ID: 2860831393 Enrollment ID: I20240417001771 |
Buffalo Medical Care Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 Genesee St, Buffalo, NY 14211 Phone: 716-895-2200 Fax: 716-895-3300 | |
Jeremiah O Sullivan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2218 Main St, Buffalo, NY 14214 Phone: 716-834-4141 Fax: 716-838-5840 | |
Greater Buffalo United Accountable Healthcare Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 564 Niagara St, Buffalo, NY 14201 Phone: 716-882-0366 Fax: 716-830-4840 | |
Buffalo Psychiatric Center Act Team Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Forest Ave, Building 51 A Area, Buffalo, NY 14213 Phone: 716-885-2261 | |
Winston G Douglas Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 755 Wehrle Dr, Buffalo, NY 14225 Phone: 716-884-8033 Fax: 716-342-2523 | |
Carewell Medical Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 462 Grider St, Buffalo, NY 14215 Phone: 716-830-5453 Fax: 716-332-3525 | |
Nutrition With Noelle P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2075 Sheridan Dr, Buffalo, NY 14223 Phone: 716-417-6388 |