| Geriatric & Palliative Specialist Pc | |
|
101 W Utica St Suite C Oswego NY 13126-3165 | |
| (315) 216-6865 | |
| (315) 216-6867 |
| Full Name | Geriatric & Palliative Specialist Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 101 W Utica St, Oswego, New York |
| Authorized Official Name and Position | Renante Ignacio (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3152164641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric & Palliative Specialist Pc 101 W Utica St Suite C Oswego NY 13126-3165 Ph: (315) 216-6865 | Geriatric & Palliative Specialist Pc 101 W Utica St Suite C Oswego NY 13126-3165 Ph: (315) 216-6865 |
| NPI Number | 1558796243 |
|---|---|
| Provider Enumeration Date | 09/12/2013 |
| Last Update Date | 03/02/2015 |
| Medicare PECOS PAC ID | 6103045950 |
|---|---|
| Medicare Enrollment ID | O20140910001036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558796243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 246837 (New York) | Primary |
| Provider Name | Renante Ignacio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861485849 PECOS PAC ID: 8729031489 Enrollment ID: I20050223000273 |
| Provider Name | Pio L Oliverio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437220399 PECOS PAC ID: 0042318503 Enrollment ID: I20070606000491 |
| Provider Name | Matthew J Gianetto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205184512 PECOS PAC ID: 8123270261 Enrollment ID: I20121218000348 |
| Provider Name | Beverly S Chartrand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124400296 PECOS PAC ID: 2163739277 Enrollment ID: I20150922000091 |
| Provider Name | Baljeet Khera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609396837 PECOS PAC ID: 0941573455 Enrollment ID: I20170905003209 |
| Provider Name | Sara P Domachowske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093492621 PECOS PAC ID: 3476907429 Enrollment ID: I20230926001518 |
| Provider Name | Billie Jo Ramachandran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235853599 PECOS PAC ID: 6800249640 Enrollment ID: I20240129003222 |
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