| La Casa De Salud Inc. | |
|
966 Prospect Ave Bronx NY 10459 | |
| (718) 991-7100 | |
| Not Available |
| Full Name | La Casa De Salud Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 966 Prospect Ave, Bronx, New York |
| Authorized Official Name and Position | Vicky Gatell (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7189607629 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Casa De Salud Inc. 311 E 175th St Bronx NY 10457-5859 Ph: (718) 960-7522 | La Casa De Salud Inc. 966 Prospect Ave Bronx NY 10459 Ph: (718) 991-7100 |
| NPI Number | 1548260870 |
|---|---|
| Provider Enumeration Date | 07/28/2005 |
| Last Update Date | 12/04/2023 |
| Medicare PECOS PAC ID | 6103913835 |
|---|---|
| Medicare Enrollment ID | O20071029000113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548260870 | NPI | - | NPPES |
| 02739320 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 7000271R (New York) | Primary |
| Provider Name | David Collymore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023000353 PECOS PAC ID: 4981696283 Enrollment ID: I20040330000518 |
| Provider Name | Arcangelo A Lubrano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447394762 PECOS PAC ID: 6800877507 Enrollment ID: I20040527001286 |
| Provider Name | Robert Balthazar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871661405 PECOS PAC ID: 1254381668 Enrollment ID: I20050124000884 |
| Provider Name | Ferdinand Banez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073656476 PECOS PAC ID: 4385696541 Enrollment ID: I20050216000060 |
| Provider Name | Emmanuel A Gachette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306874979 PECOS PAC ID: 7214942093 Enrollment ID: I20060215000484 |
| Provider Name | Lucy Palomino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871611319 PECOS PAC ID: 7214935725 Enrollment ID: I20071001000451 |
| Provider Name | Kingsley Nwokeji |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578645255 PECOS PAC ID: 6305928326 Enrollment ID: I20080130000337 |
| Provider Name | Flora Antwi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033348677 PECOS PAC ID: 4789853243 Enrollment ID: I20110818000157 |
| Provider Name | Evelyn M Figueroa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437491818 PECOS PAC ID: 6406083591 Enrollment ID: I20131217001171 |
| Provider Name | Carline Lamour-occean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952654188 PECOS PAC ID: 4183846298 Enrollment ID: I20141105000584 |
| Provider Name | Angela M Holland-ridges |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1780941195 PECOS PAC ID: 0042534240 Enrollment ID: I20150116001475 |
| Provider Name | Maria A Toloza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427462027 PECOS PAC ID: 6002108040 Enrollment ID: I20160712000920 |
| Provider Name | Edith L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750698445 PECOS PAC ID: 8729361548 Enrollment ID: I20170201001752 |
| Provider Name | Iyona Js Jeya Chandran |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1255774667 PECOS PAC ID: 0446535249 Enrollment ID: I20170317000640 |
| Provider Name | Vivian M Medina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063659449 PECOS PAC ID: 3375819485 Enrollment ID: I20171017002865 |
| Provider Name | Debra A Mestre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699210633 PECOS PAC ID: 0941568745 Enrollment ID: I20171228001174 |
| Provider Name | Franchesca Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679093827 PECOS PAC ID: 7113282880 Enrollment ID: I20180530000850 |
| Provider Name | Joana Marie M Abitan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922537158 PECOS PAC ID: 0648525600 Enrollment ID: I20180614001591 |
| Provider Name | Rosario Vanessa Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982023073 PECOS PAC ID: 5890032684 Enrollment ID: I20190201001382 |
| Provider Name | Dasola Okunola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669902151 PECOS PAC ID: 1658760509 Enrollment ID: I20211115001138 |
| Provider Name | Roselyn Conesa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619645132 PECOS PAC ID: 8820487796 Enrollment ID: I20211115001631 |
| Provider Name | Julissa Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326708348 PECOS PAC ID: 9739573486 Enrollment ID: I20220223002431 |
| Provider Name | Jonathan Dnp Ringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144750860 PECOS PAC ID: 7214323930 Enrollment ID: I20220406001112 |
| Provider Name | Molly K Rudinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962059022 PECOS PAC ID: 5890161178 Enrollment ID: I20221012002134 |
| Provider Name | Catherine J Schulok |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639839319 PECOS PAC ID: 2365894433 Enrollment ID: I20240115001300 |
| Provider Name | Rafael Roa Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669125852 PECOS PAC ID: 5193161917 Enrollment ID: I20240314002122 |
| Provider Name | Renee R Hartwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033620273 PECOS PAC ID: 8224570643 Enrollment ID: I20240612003347 |
Mmc Medical Park At 1635 Poplar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Mmc Medical Park At 1635 Poplar, 1635 Poplar Street, Bronx, NY 10461 Phone: 914-377-4722 | |
Mmc At Aecom Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1300 Morris Park Avenue, Mmc At Aecom, Bronx, NY 10461 Phone: 914-377-4722 | |
Brightpoint Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1543-1545 Inwood Avenue, Bronx, NY 10452 Phone: 855-687-8700 Fax: 718-294-4765 | |
Aramark Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1650 Grand Concourse, Bronx, NY 10457 Phone: 646-641-7427 | |
Mmc At Melrose 260 E 161 Street Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 E 161st St, Bronx, NY 10451 Phone: 718-920-4321 | |
Amth Medical Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 369 E 149th St, 4th Floor, Bronx, NY 10455 Phone: 718-665-8300 | |
New Genesis Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3485 E Tremont Ave Fl 2, Bronx, NY 10465 Phone: 718-828-1549 Fax: 516-303-0968 |