| Hickory Care Llc | |
|
1700 Monroe Ave Maitland FL 32751-6672 | |
| (407) 647-2092 | |
| Not Available |
| Full Name | Hickory Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1700 Monroe Ave, Maitland, Florida |
| Authorized Official Name and Position | Moshe Feferkorn (OWNER) |
| Authorized Official Contact | 7189309911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hickory Care Llc 52 Harmony Dr Lakewood NJ 08701-5841 Ph: (732) 631-4358 | Hickory Care Llc 1700 Monroe Ave Maitland FL 32751-6672 Ph: (407) 647-2092 |
| NPI Number | 1124899869 |
|---|---|
| Provider Enumeration Date | 01/11/2024 |
| Last Update Date | 01/11/2024 |
| Medicare PECOS PAC ID | 7315384997 |
|---|---|
| Medicare Enrollment ID | O20240318003753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124899869 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Hannah Labove |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477087146 PECOS PAC ID: 3274944343 Enrollment ID: I20210126001599 |
| Provider Name | Lillian Christine Mack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275296055 PECOS PAC ID: 3971997354 Enrollment ID: I20220301000822 |
| Provider Name | Mateusz Lapucha |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1992191266 PECOS PAC ID: 1355634361 Enrollment ID: I20230504000993 |
| Provider Name | Vanessa Julie Trovela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447963749 PECOS PAC ID: 8325401409 Enrollment ID: I20230823002111 |
| Provider Name | Patricia Siatta Tulay-robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780927772 PECOS PAC ID: 2062864663 Enrollment ID: I20240119000430 |
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