| Medalliance Medical Health Services Inc | |
|
625 E Fordham Rd Bronx NY 10458-5049 | |
| (718) 933-1900 | |
| (718) 563-4039 |
| Full Name | Medalliance Medical Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 625 E Fordham Rd, Bronx, New York |
| Authorized Official Name and Position | Shahriar Daneshvar (CEO) |
| Authorized Official Contact | 7189331900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medalliance Medical Health Services Inc 625 E Fordham Rd Bronx NY 10458-5049 Ph: (718) 933-1900 | Medalliance Medical Health Services Inc 625 E Fordham Rd Bronx NY 10458-5049 Ph: (718) 933-1900 |
| NPI Number | 1558356741 |
|---|---|
| Provider Enumeration Date | 09/14/2005 |
| Last Update Date | 12/30/2014 |
| Medicare PECOS PAC ID | 4789633678 |
|---|---|
| Medicare Enrollment ID | O20050118000826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558356741 | NPI | - | NPPES |
| 02619203 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0261903 (New York) | Primary |
| Provider Name | Daniel Eli Beyda |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437136579 PECOS PAC ID: 5799698577 Enrollment ID: I20031107000356 |
| Provider Name | Gabriel L Dassa |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366461436 PECOS PAC ID: 3173410438 Enrollment ID: I20040302000198 |
| Provider Name | Boris G Chusid |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518967769 PECOS PAC ID: 3577453554 Enrollment ID: I20040316000520 |
| Provider Name | Nicholas J Gargiulo |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1447332614 PECOS PAC ID: 7719877968 Enrollment ID: I20040319000395 |
| Provider Name | Carmen S Costas Katz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407918675 PECOS PAC ID: 3476445602 Enrollment ID: I20040325000118 |
| Provider Name | Raz Winiarsky |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992769061 PECOS PAC ID: 2860484599 Enrollment ID: I20040401000648 |
| Provider Name | Murray David Schwalb |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1851368468 PECOS PAC ID: 5597757054 Enrollment ID: I20040402000515 |
| Provider Name | Elaine R Williams |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710959945 PECOS PAC ID: 4082606561 Enrollment ID: I20040402000629 |
| Provider Name | Nilesh Balar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568460491 PECOS PAC ID: 8921093550 Enrollment ID: I20040414001842 |
| Provider Name | Richard Gasalberti |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043324759 PECOS PAC ID: 0840287561 Enrollment ID: I20040426001763 |
| Provider Name | Joseph D'amore |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1932193513 PECOS PAC ID: 9436145463 Enrollment ID: I20040507001358 |
| Provider Name | Ira H Kirschenbaum |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396723482 PECOS PAC ID: 5597678953 Enrollment ID: I20040512000625 |
| Provider Name | Ashanda Saint Jean |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487668067 PECOS PAC ID: 5193715779 Enrollment ID: I20040514001254 |
| Provider Name | Andrew R Miller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801868419 PECOS PAC ID: 1759362718 Enrollment ID: I20040526000314 |
| Provider Name | Jeffrey Guttman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043253487 PECOS PAC ID: 7618956368 Enrollment ID: I20040715001243 |
| Provider Name | Jeffrey M Weinberg |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1689660565 PECOS PAC ID: 5698754265 Enrollment ID: I20040716000691 |
| Provider Name | Vadim Kushnerik |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1740244771 PECOS PAC ID: 2365428547 Enrollment ID: I20040727001645 |
| Provider Name | David Jakubowicz |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538169230 PECOS PAC ID: 6709856453 Enrollment ID: I20040729000505 |
| Provider Name | Tatyana R. Gitlevich |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700886983 PECOS PAC ID: 8426019837 Enrollment ID: I20041020000019 |
| Provider Name | Sasan Azar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275596793 PECOS PAC ID: 9739161183 Enrollment ID: I20041109000382 |
| Provider Name | Robert Valenzuela |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962400879 PECOS PAC ID: 3274598685 Enrollment ID: I20041124000821 |
| Provider Name | Mark J Klion |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972610798 PECOS PAC ID: 1658328075 Enrollment ID: I20050407000033 |
| Provider Name | Azriel Benaroya |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962445122 PECOS PAC ID: 9234162140 Enrollment ID: I20050912001176 |
| Provider Name | Srinivas Kesanakurthy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770558397 PECOS PAC ID: 5890714356 Enrollment ID: I20051115000223 |
| Provider Name | Dilip S Doctor |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1134291420 PECOS PAC ID: 6305852047 Enrollment ID: I20060303000585 |
| Provider Name | Ali E Guy |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1588722623 PECOS PAC ID: 5496852352 Enrollment ID: I20070530000019 |
| Provider Name | Leonard Luna |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669536363 PECOS PAC ID: 4688772346 Enrollment ID: I20070605000193 |
| Provider Name | Sajjad Mohammad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033290242 PECOS PAC ID: 3274632997 Enrollment ID: I20070621000199 |
| Provider Name | Anthony R Iorio |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821105966 PECOS PAC ID: 9537125455 Enrollment ID: I20070622000479 |
| Provider Name | Mayank V Patel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902804768 PECOS PAC ID: 2365493988 Enrollment ID: I20070905000042 |
| Provider Name | Parind M Oza |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194847525 PECOS PAC ID: 3577656719 Enrollment ID: I20070905000257 |
| Provider Name | Robert N Holtzman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1164571691 PECOS PAC ID: 9335242627 Enrollment ID: I20070906000484 |
| Provider Name | Sana Bloch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760456933 PECOS PAC ID: 8729168000 Enrollment ID: I20071228000318 |
| Provider Name | Svetlana Trounina |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457557514 PECOS PAC ID: 1052491446 Enrollment ID: I20080110000625 |
| Provider Name | Ramon E Ravelo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437172426 PECOS PAC ID: 1951470814 Enrollment ID: I20080519000111 |
| Provider Name | Timothy E Ryntz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497736847 PECOS PAC ID: 8022015528 Enrollment ID: I20080715000732 |
| Provider Name | Agnieszka Kokoszka |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326206285 PECOS PAC ID: 7214003409 Enrollment ID: I20080912000240 |
| Provider Name | Alfonso A Ortiz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1699915967 PECOS PAC ID: 5193882066 Enrollment ID: I20090319000516 |
| Provider Name | Joshua Auerbach |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881754448 PECOS PAC ID: 6406909746 Enrollment ID: I20090804000112 |
| Provider Name | Bindu Pathrose |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1346436094 PECOS PAC ID: 6103970884 Enrollment ID: I20090814000155 |
| Provider Name | Hanny M Hernandez |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1073746558 PECOS PAC ID: 2062542392 Enrollment ID: I20100614000455 |
| Provider Name | Edwin Thompson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1295963817 PECOS PAC ID: 4284750365 Enrollment ID: I20100927000231 |
| Provider Name | Ali A Ahmadizadeh |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1376598805 PECOS PAC ID: 0941294904 Enrollment ID: I20101203000913 |
| Provider Name | Lennart Belok |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215027412 PECOS PAC ID: 2163611658 Enrollment ID: I20110114000331 |
| Provider Name | Linda A Shookster |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1073551537 PECOS PAC ID: 8224210711 Enrollment ID: I20110406000936 |
| Provider Name | Haleh Nassiri |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013293166 PECOS PAC ID: 9133389000 Enrollment ID: I20120330000117 |
| Provider Name | Asiya S Tschannerl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730460320 PECOS PAC ID: 5597927624 Enrollment ID: I20120507000224 |
| Provider Name | Hernando Orjuela |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295732253 PECOS PAC ID: 3779532007 Enrollment ID: I20120807000474 |
| Provider Name | Ruchi A Shah |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922343086 PECOS PAC ID: 8921243684 Enrollment ID: I20130328000416 |
| Provider Name | Lamercie M Jean-jacques |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427395672 PECOS PAC ID: 6608012067 Enrollment ID: I20130410000192 |
| Provider Name | Aimee A Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922359686 PECOS PAC ID: 2264675230 Enrollment ID: I20130823001079 |
| Provider Name | Martha P Yepes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023455607 PECOS PAC ID: 2264676857 Enrollment ID: I20130923000029 |
| 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 | Ashwani Sastry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073771309 PECOS PAC ID: 7113142324 Enrollment ID: I20140702000225 |
| Provider Name | Kab Ju Kim-amaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851790315 PECOS PAC ID: 1850615410 Enrollment ID: I20150130001409 |
| Provider Name | Oladapo M Babatunde |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083857593 PECOS PAC ID: 2163741729 Enrollment ID: I20150501001529 |
| Provider Name | Kan Zhang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023264157 PECOS PAC ID: 4688988272 Enrollment ID: I20150727000941 |
| Provider Name | Omar Noor |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1124319397 PECOS PAC ID: 5496061723 Enrollment ID: I20150902000230 |
| Provider Name | Simon Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740532613 PECOS PAC ID: 8224274485 Enrollment ID: I20151014002964 |
| Provider Name | Sreejit Nair |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1750517520 PECOS PAC ID: 1355650672 Enrollment ID: I20151027001144 |
| Provider Name | Juan A Escarfuller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962443127 PECOS PAC ID: 6002821568 Enrollment ID: I20151124002064 |
| Provider Name | Diarra A Aguirre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730556341 PECOS PAC ID: 9830499557 Enrollment ID: I20151202002792 |
| Provider Name | Scott Lloyd |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942686985 PECOS PAC ID: 5193026979 Enrollment ID: I20151221001521 |
| Provider Name | Corey K Goldman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467482331 PECOS PAC ID: 3274602941 Enrollment ID: I20160629001096 |
| Provider Name | Main Uddin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386999035 PECOS PAC ID: 1254619190 Enrollment ID: I20161028000306 |
| Provider Name | Sachin Kumar Amruthlal Jain |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134384951 PECOS PAC ID: 1355586777 Enrollment ID: I20170913002960 |
| Provider Name | Abuhuziefa Abubakr |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932109378 PECOS PAC ID: 6608891395 Enrollment ID: I20171004001201 |
| Provider Name | Christos C Christolias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750728051 PECOS PAC ID: 0446526057 Enrollment ID: I20171026002468 |
| Provider Name | Judithe Apollon-louissaint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902200520 PECOS PAC ID: 7618243163 Enrollment ID: I20171027000782 |
| Provider Name | Samy Saker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134413172 PECOS PAC ID: 2062779234 Enrollment ID: I20180530001322 |
| Provider Name | Hong Sik Pak |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1427077056 PECOS PAC ID: 6103710298 Enrollment ID: I20190426000937 |
| Provider Name | Carmela Maria Marchese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346651049 PECOS PAC ID: 9335475029 Enrollment ID: I20190802000583 |
| Provider Name | Richard Daniels |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1417905043 PECOS PAC ID: 3577476837 Enrollment ID: I20200918000862 |
| Provider Name | Gayoung Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205474467 PECOS PAC ID: 8224429063 Enrollment ID: I20220105000728 |
| Provider Name | Kartik Kottapalli |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538754288 PECOS PAC ID: 6800287681 Enrollment ID: I20220105002230 |
| Provider Name | Gianna Joanne Link |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053428870 PECOS PAC ID: 3779514773 Enrollment ID: I20220712002808 |
| Provider Name | Anna Wisniewska |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306200357 PECOS PAC ID: 1456727908 Enrollment ID: I20221025000788 |
| Provider Name | Natalia Feldman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992330658 PECOS PAC ID: 3274995998 Enrollment ID: I20230811003442 |
| Provider Name | Maria Altagracia Bello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558055814 PECOS PAC ID: 4789038688 Enrollment ID: I20230926004106 |
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