| Primary Care Services | |
|
1 Long Wharf Dr New Haven CT 06511-5991 | |
| (203) 781-4640 | |
| (203) 781-4682 |
| Full Name | Primary Care Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Long Wharf Dr, New Haven, Connecticut |
| Authorized Official Name and Position | Lynn M Madden (PRESIDENT, CEO) |
| Authorized Official Contact | 2037814600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Services 1 Long Wharf Dr Ste 321 New Haven CT 06511-5991 Ph: (203) 781-4600 | Primary Care Services 1 Long Wharf Dr New Haven CT 06511-5991 Ph: (203) 781-4640 |
| NPI Number | 1801950951 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 03/30/2017 |
| Medicare PECOS PAC ID | 8729250204 |
|---|---|
| Medicare Enrollment ID | O20111005000111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801950951 | NPI | - | NPPES |
| 008066315 | Other | CT | COLON RIVERA MEDICAID |
| 008066948 | Other | CT | LOUIE MEDICAID |
| 001218107 | Other | CT | SCHOTTENFELD MEDICAID |
| 001272286 | Medicaid | CT | |
| 001307439 | Other | CT | ALTICE MEDICAID |
| 008040283 | Other | CT | CAMENGA MEDICAID |
| 008063396 | Other | CT | MEMISEVICH MEDICAID |
| 008066801 | Other | CT | HAQUE MEDICAID |
| 001340132 | Other | CT | SAVAGE MEDICAID |
| 001423135 | Other | CT | TETRAULT MEDICAID |
| 004217099 | Other | CT | PCS LONG WHARF MEDICAID |
| 008003745 | Other | CT | DESROSIERS MEDICAID |
| 008053091 | Other | CT | BUTNER MEDICAID |
| 001302497 | Other | CT | SHI MEDICAID |
| 008037391 | Other | CT | SHACKELL MEDICAID |
| 008058058 | Other | CT | SADINSKY MEDICAID |
| 008069118 | Other | CT | CAMPBELL MEDICAID # |
| 008066293 | Other | CT | MARDAM BEY MEDICAID |
| 008068420 | Other | CT | SCHEFILITI MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0000610 (Connecticut) | Primary |
| Provider Name | Jeanette M Tetrault |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003841321 PECOS PAC ID: 5294714507 Enrollment ID: I20041123000765 |
| Provider Name | Daniel A Iead |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952444382 PECOS PAC ID: 0941239636 Enrollment ID: I20050812000274 |
| Provider Name | Susan C Feldman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134197684 PECOS PAC ID: 2769492321 Enrollment ID: I20060426000602 |
| Provider Name | Frederick Lewis Altice |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710960158 PECOS PAC ID: 9234265638 Enrollment ID: I20100324000918 |
| Provider Name | Deepa Camenga |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952318214 PECOS PAC ID: 8224291513 Enrollment ID: I20120524000179 |
| Provider Name | Gretchen L Hermes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710161948 PECOS PAC ID: 2567614332 Enrollment ID: I20121203000080 |
| Provider Name | Julia M Shi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972513125 PECOS PAC ID: 9537311162 Enrollment ID: I20121206000253 |
| Provider Name | Amanda A Shackell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295982429 PECOS PAC ID: 7416102652 Enrollment ID: I20130219000526 |
| Provider Name | Katie Louie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548612518 PECOS PAC ID: 4688969371 Enrollment ID: I20160819000492 |
| Provider Name | Jessica Di Fabio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508315730 PECOS PAC ID: 2264711845 Enrollment ID: I20161123000517 |
| Provider Name | Sharmain Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720420342 PECOS PAC ID: 9537441589 Enrollment ID: I20170126001832 |
| Provider Name | Diane Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194935940 PECOS PAC ID: 0941585814 Enrollment ID: I20170316001808 |
| Provider Name | Kenneth Morford |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1083059984 PECOS PAC ID: 8325368319 Enrollment ID: I20170724003515 |
| Provider Name | Aaron Roberto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275896029 PECOS PAC ID: 4789955915 Enrollment ID: I20170807002947 |
| Provider Name | Julia E Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629543277 PECOS PAC ID: 3476897786 Enrollment ID: I20181127002403 |
| Provider Name | Savitra Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740683614 PECOS PAC ID: 4981943420 Enrollment ID: I20190228001525 |
| Provider Name | Lorianne Meus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255974770 PECOS PAC ID: 2163858960 Enrollment ID: I20200213001605 |
| Provider Name | Kimberly Sue |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295116705 PECOS PAC ID: 3274840319 Enrollment ID: I20210107002922 |
| Provider Name | Megan Mary Kelly Gilman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669018123 PECOS PAC ID: 6709299670 Enrollment ID: I20210114000259 |
| Provider Name | James Edward Yaffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982631834 PECOS PAC ID: 9638571672 Enrollment ID: I20210713001781 |
| Provider Name | Benjamin Joseph Mahoney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033788237 PECOS PAC ID: 8022411750 Enrollment ID: I20210719002746 |
| Provider Name | Mary Frances Giannotti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730859810 PECOS PAC ID: 8628466885 Enrollment ID: I20211021001155 |
| Provider Name | Breann Artes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982243341 PECOS PAC ID: 9830581362 Enrollment ID: I20220113001085 |
| Provider Name | Katherine Kelly D'angelo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609523430 PECOS PAC ID: 4880061993 Enrollment ID: I20221102002446 |
| Provider Name | Jordyn Panicali |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659080968 PECOS PAC ID: 6002285111 Enrollment ID: I20221213000832 |
| Provider Name | Yvonne Bolumole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720559438 PECOS PAC ID: 9931555091 Enrollment ID: I20231025002189 |
| Provider Name | Alexandra Marie Raucci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821879396 PECOS PAC ID: 5193172526 Enrollment ID: I20231107002330 |
| Provider Name | Meredith Barone |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669981940 PECOS PAC ID: 8921451816 Enrollment ID: I20240126002260 |
| Provider Name | Adam Sarmiento |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194366542 PECOS PAC ID: 9830542729 Enrollment ID: I20240126002261 |
| Provider Name | Sarah Marty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487434809 PECOS PAC ID: 6002269990 Enrollment ID: I20240126002338 |
| Provider Name | Danya R Guttman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376035386 PECOS PAC ID: 9335592229 Enrollment ID: I20240126002434 |
| Provider Name | Christine Elizabeth Tirado |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427690841 PECOS PAC ID: 0648623546 Enrollment ID: I20240126002701 |
| Provider Name | Maria Nunley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013325018 PECOS PAC ID: 5395198204 Enrollment ID: I20240126003073 |
| Provider Name | John Mckeithen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770772576 PECOS PAC ID: 3678926425 Enrollment ID: I20240128000104 |
| Provider Name | Toni-michelle Storlazzi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740753367 PECOS PAC ID: 6608229356 Enrollment ID: I20240129003793 |
| Provider Name | Sheiketha Ross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265836902 PECOS PAC ID: 5092168716 Enrollment ID: I20240130001516 |
| Provider Name | Jessica Means |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477960862 PECOS PAC ID: 8325491954 Enrollment ID: I20240130002074 |
| Provider Name | Trusenia Onofrio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821211061 PECOS PAC ID: 2668825282 Enrollment ID: I20240131001428 |
| Provider Name | Scott Orff Farnum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427298942 PECOS PAC ID: 5991158370 Enrollment ID: I20240201002562 |
| Provider Name | Brian Adam Bonilla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679112569 PECOS PAC ID: 5395181861 Enrollment ID: I20240307001318 |
| Provider Name | Adam David Olszyk |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184489478 PECOS PAC ID: 1850737792 Enrollment ID: I20240313003039 |
| Provider Name | Belphoebe Rabia Zufferey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831953785 PECOS PAC ID: 3971940552 Enrollment ID: I20240318003701 |
Luis R. Cruz, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1552 Chapel St, New Haven, CT 06511 Phone: 203-624-2117 | |
Fair Haven Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 426 East St, New Haven, CT 06511 Phone: 203-777-7411 Fax: 203-777-8506 | |
New Haven Public Schools Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 Meadow St, New Haven, CT 06519 Phone: 203-946-8969 Fax: 203-946-8664 | |
Leonard A . Fasano Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 980 Whalley Ave, New Haven, CT 06515 Phone: 203-387-2569 Fax: 203-387-9245 | |
Cardiology Associates Of New Haven, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Temple St, New Haven, CT 06510 Phone: 203-789-2272 Fax: 203-287-3963 | |
Yale New Haven Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-9335 | |
Sg Medical Professionals Ct Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 Clifton St, New Haven, CT 06513 Phone: 718-362-1403 Fax: 718-414-1651 |