| Healthsource Medical Services Medford, Pllc | |
|
1743 N Ocean Ave Medford NY 11763-2649 | |
| (631) 758-3100 | |
| (631) 758-3168 |
| Full Name | Healthsource Medical Services Medford, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1743 N Ocean Ave, Medford, New York |
| Authorized Official Name and Position | John Folan (PRESIDENT/OWNER) |
| Authorized Official Contact | 6314350110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Medical Services Medford, Pllc 3001 Express Dr N Suite 200c Islandia NY 11749-5301 Ph: (631) 435-0110 | Healthsource Medical Services Medford, Pllc 1743 N Ocean Ave Medford NY 11763-2649 Ph: (631) 758-3100 |
| NPI Number | 1821319575 |
|---|---|
| Provider Enumeration Date | 06/17/2010 |
| Last Update Date | 06/17/2010 |
| Medicare PECOS PAC ID | 0143413344 |
|---|---|
| Medicare Enrollment ID | O20101020000911 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821319575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 167755 (New York) | Primary |
| Provider Name | Michael Ryder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659598589 PECOS PAC ID: 8820984446 Enrollment ID: I20040223000258 |
| Provider Name | Keith A Clement |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528058732 PECOS PAC ID: 9739129453 Enrollment ID: I20050511000846 |
| Provider Name | Joan A Scalera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881812543 PECOS PAC ID: 7911047485 Enrollment ID: I20091214000387 |
| Provider Name | John F Folan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780801605 PECOS PAC ID: 7214823830 Enrollment ID: I20100831000856 |
| Provider Name | Beth A. Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134434129 PECOS PAC ID: 9931385119 Enrollment ID: I20110602000562 |
| Provider Name | Cheriyan Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619248481 PECOS PAC ID: 6305080946 Enrollment ID: I20130920000206 |
| Provider Name | Anna Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255729802 PECOS PAC ID: 1355661711 Enrollment ID: I20150526002411 |
| Provider Name | Zeeshan Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144668864 PECOS PAC ID: 2769778299 Enrollment ID: I20160909001795 |
| Provider Name | Kristan Elaina Probeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780944363 PECOS PAC ID: 3779883053 Enrollment ID: I20161101000364 |
| Provider Name | Jill Farrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710415088 PECOS PAC ID: 1850669391 Enrollment ID: I20170626000084 |
| Provider Name | Kristin Marie Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942613203 PECOS PAC ID: 0042575227 Enrollment ID: I20180629001664 |
Kami Quinn Medical Doctor Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 76 Southaven Ave, Suite 4, Medford, NY 11763 Phone: 631-569-4055 Fax: 631-569-4056 | |
Provident Health Partners Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1529 N Ocean Ave Ste A, Medford, NY 11763 Phone: 631-266-4501 Fax: 631-266-4502 | |
South Island Medical Care Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 76 Southaven Ave, Suite 5, Medford, NY 11763 Phone: 631-447-8860 Fax: 631-447-8862 | |
Island Medical Of Medford, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1647 Route 112, Medford, NY 11763 Phone: 631-758-2220 Fax: 631-758-8355 |