| Longevity Long Term Medical Care Of Pennsylvania Pllc | |
|
2595 Interstate Dr Ste 103 Harrisburg PA 17110-9378 | |
| (561) 815-2427 | |
| Not Available |
| Full Name | Longevity Long Term Medical Care Of Pennsylvania Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2595 Interstate Dr Ste 103, Harrisburg, Pennsylvania |
| Authorized Official Name and Position | Diane Vincur (PRACTICE MANAGER) |
| Authorized Official Contact | 5618152427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Long Term Medical Care Of Pennsylvania Pllc 11770 Us Highway 1 Ste N107 Palm Beach Gardens FL 33408-3027 Ph: (561) 815-2427 | Longevity Long Term Medical Care Of Pennsylvania Pllc 2595 Interstate Dr Ste 103 Harrisburg PA 17110-9378 Ph: (561) 815-2427 |
| NPI Number | 1720796196 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 11/14/2022 |
| Medicare PECOS PAC ID | 0042680506 |
|---|---|
| Medicare Enrollment ID | O20221228001937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720796196 | NPI | - | NPPES |
| Provider Name | Gigi Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942682505 PECOS PAC ID: 1759693617 Enrollment ID: I20150707000328 |
| Provider Name | Carla Hogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508233446 PECOS PAC ID: 7618279241 Enrollment ID: I20160113001503 |
| Provider Name | Ahone Ngalame |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548562200 PECOS PAC ID: 9133430630 Enrollment ID: I20170607002323 |
| Provider Name | Jaclyn Swink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275990806 PECOS PAC ID: 6204131188 Enrollment ID: I20171026002148 |
| Provider Name | Casey Delacy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508218546 PECOS PAC ID: 5991085409 Enrollment ID: I20171031002789 |
| Provider Name | Patricia F Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861947129 PECOS PAC ID: 4284993668 Enrollment ID: I20180110000554 |
| Provider Name | Laura Krueger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932672128 PECOS PAC ID: 0042557472 Enrollment ID: I20190123003114 |
| Provider Name | Risha Aney Binu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902361884 PECOS PAC ID: 8224370259 Enrollment ID: I20190423002443 |
| Provider Name | Jancy Manoj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871142406 PECOS PAC ID: 6103158241 Enrollment ID: I20191023000673 |
| Provider Name | Daniella O Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275154817 PECOS PAC ID: 2365863586 Enrollment ID: I20200526001946 |
| Provider Name | Jennifer Sabia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255929345 PECOS PAC ID: 2466865282 Enrollment ID: I20210114003000 |
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