| Riverdale Family Practice | |
|
3050 Corlear Ave Suite 201 Bronx NY 10463-3815 | |
| (718) 543-2700 | |
| (718) 601-0965 |
| Full Name | Riverdale Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 3050 Corlear Ave, Bronx, New York |
| Authorized Official Name and Position | Frank J Maselli (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7185432700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverdale Family Practice 3050 Corlear Ave Suite 201 Bronx NY 10463-5180 Ph: (718) 543-2700 | Riverdale Family Practice 3050 Corlear Ave Suite 201 Bronx NY 10463-3815 Ph: (718) 543-2700 |
| NPI Number | 1912059239 |
|---|---|
| Provider Enumeration Date | 01/17/2007 |
| Last Update Date | 07/09/2015 |
| Medicare PECOS PAC ID | 9335243930 |
|---|---|
| Medicare Enrollment ID | O20070409000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912059239 | NPI | - | NPPES |
| WWQ371 | Other | NY | MEDICARE/GROUP# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jill E Groves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700979119 PECOS PAC ID: 8527016237 Enrollment ID: I20050110000771 |
| Provider Name | Roger A Villi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376636787 PECOS PAC ID: 9931115581 Enrollment ID: I20060306000674 |
| Provider Name | Frank J Maselli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215020607 PECOS PAC ID: 9234233834 Enrollment ID: I20070409000059 |
| Provider Name | Carl Franzetti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124111521 PECOS PAC ID: 2961506563 Enrollment ID: I20070409000063 |
| Provider Name | Leticia Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174616577 PECOS PAC ID: 5193829745 Enrollment ID: I20070409000461 |
| Provider Name | Robin R Pinzon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912296641 PECOS PAC ID: 7113199670 Enrollment ID: I20111006000188 |
| Provider Name | Teresa Hervada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194823237 PECOS PAC ID: 3971750159 Enrollment ID: I20120822000621 |
| Provider Name | Maria Lourdes R Flores |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588009559 PECOS PAC ID: 0648490219 Enrollment ID: I20141002000147 |
| Provider Name | Liliana M Taich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629413372 PECOS PAC ID: 5991029217 Enrollment ID: I20150115000483 |
| Provider Name | Michelle A Zevallos-ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760868012 PECOS PAC ID: 9133438997 Enrollment ID: I20151016001382 |
| Provider Name | Ansa S Kandamkulathy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942807136 PECOS PAC ID: 4486067279 Enrollment ID: I20210118000026 |
| Provider Name | Charity N Excel Okechukwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417490707 PECOS PAC ID: 1153738836 Enrollment ID: I20210324002317 |
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