| New York Patient Medical Care Pc | |
|
510 Clinton Sq Rochester NY 14604-1700 | |
| (646) 263-3680 | |
| Not Available |
| Full Name | New York Patient Medical Care Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 Clinton Sq, Rochester, New York |
| Authorized Official Name and Position | Eric Yecies (CCO) |
| Authorized Official Contact | 6462633680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New York Patient Medical Care Pc 236 5th Ave Ste 400 New York NY 10001-7606 Ph: (800) 852-1575 | New York Patient Medical Care Pc 510 Clinton Sq Rochester NY 14604-1700 Ph: (646) 263-3680 |
| NPI Number | 1629757919 |
|---|---|
| Provider Enumeration Date | 07/13/2023 |
| Last Update Date | 05/28/2024 |
| Medicare PECOS PAC ID | 4183060643 |
|---|---|
| Medicare Enrollment ID | O20240307001082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629757919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Payel Gupta |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1457533077 PECOS PAC ID: 1759574007 Enrollment ID: I20101020000083 |
| Provider Name | Shanta Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154806172 PECOS PAC ID: 3173944642 Enrollment ID: I20221129003119 |
| Provider Name | Dina Whiteaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578841490 PECOS PAC ID: 5294953576 Enrollment ID: I20230815000191 |
| Provider Name | Anthony Puopolo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275602625 PECOS PAC ID: 5890854442 Enrollment ID: I20240307001168 |
| Provider Name | Banita Banu Sehgal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942212527 PECOS PAC ID: 5193917003 Enrollment ID: I20240307003762 |
| Provider Name | Jonathan Guirguis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861767113 PECOS PAC ID: 3375858871 Enrollment ID: I20240404000837 |
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