| Saint Peter's Specialty Physicians, P.c. | |
|
2290 W County Line Rd Ste 101 Jackson NJ 08527-2156 | |
| (732) 565-5471 | |
| (732) 745-2163 |
| Full Name | Saint Peter's Specialty Physicians, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2290 W County Line Rd Ste 101, Jackson, New Jersey |
| Authorized Official Name and Position | Susan Mc Manus (PRESIDENT) |
| Authorized Official Contact | 7328463300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Peter's Specialty Physicians, P.c. 254 Easton Avenue Attn: Managed Care Department New Brunswick NJ 08901-1766 Ph: (732) 565-5453 | Saint Peter's Specialty Physicians, P.c. 2290 W County Line Rd Ste 101 Jackson NJ 08527-2156 Ph: (732) 565-5471 |
| NPI Number | 1861894982 |
|---|---|
| Provider Enumeration Date | 09/19/2014 |
| Last Update Date | 03/06/2020 |
| Medicare PECOS PAC ID | 8426373952 |
|---|---|
| Medicare Enrollment ID | O20150204001582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861894982 | NPI | - | NPPES |
| Provider Name | Weizhen Xu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881787604 PECOS PAC ID: 1759278583 Enrollment ID: I20040304000409 |
| Provider Name | John Gallucci |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245295153 PECOS PAC ID: 5890686778 Enrollment ID: I20040322000574 |
| Provider Name | Gregg Giannina |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285704213 PECOS PAC ID: 8628064441 Enrollment ID: I20040426000233 |
| Provider Name | Carlos W Benito |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487610952 PECOS PAC ID: 0345237558 Enrollment ID: I20040429000302 |
| Provider Name | Anup Singh |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1245225242 PECOS PAC ID: 2365426616 Enrollment ID: I20040615001239 |
| Provider Name | Carlos R Lastra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144249137 PECOS PAC ID: 3870537160 Enrollment ID: I20050620000521 |
| Provider Name | Debra R Goldstein |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619966850 PECOS PAC ID: 0042246316 Enrollment ID: I20050711000009 |
| Provider Name | Susan R Brill-goldberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487602033 PECOS PAC ID: 1153332655 Enrollment ID: I20060517000075 |
| Provider Name | Victoria Surgan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073603007 PECOS PAC ID: 5193725786 Enrollment ID: I20070104000354 |
| Provider Name | Archana Singh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1902139561 PECOS PAC ID: 0345382750 Enrollment ID: I20100123000123 |
| Provider Name | Harumi Jyonouchi |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1225177090 PECOS PAC ID: 0244416238 Enrollment ID: I20110509000189 |
| Provider Name | Nibal A Zaghloul |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447251764 PECOS PAC ID: 6901812247 Enrollment ID: I20110523000331 |
| Provider Name | Diana N Traquina |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1669533766 PECOS PAC ID: 3375721665 Enrollment ID: I20110712000040 |
| Provider Name | Meredith M Hunter Elischer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1841586435 PECOS PAC ID: 5294993705 Enrollment ID: I20120229000591 |
| Provider Name | Ashwin R Jadhav |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457675159 PECOS PAC ID: 4284822073 Enrollment ID: I20121204000174 |
| Provider Name | Revital D Faro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275892812 PECOS PAC ID: 8527281732 Enrollment ID: I20140515001067 |
| Provider Name | Arkady Broder |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336307529 PECOS PAC ID: 9739304841 Enrollment ID: I20140703001523 |
| Provider Name | Kianoush Sheykholeslami |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841480274 PECOS PAC ID: 8628123080 Enrollment ID: I20141106001683 |
| Provider Name | Janelle Foroutan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215222534 PECOS PAC ID: 9739347071 Enrollment ID: I20141211001171 |
| Provider Name | Rupinder K Gill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649484791 PECOS PAC ID: 2668641028 Enrollment ID: I20150728003709 |
| Provider Name | Swati Lotlikar Kamath |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1740470228 PECOS PAC ID: 5597075069 Enrollment ID: I20151112002519 |
| Provider Name | Kristy Palomares |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346684701 PECOS PAC ID: 7810296720 Enrollment ID: I20170330001844 |
| Provider Name | Kristin M Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801056643 PECOS PAC ID: 1254607989 Enrollment ID: I20171025001874 |
| Provider Name | Amie Kawashima |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003137837 PECOS PAC ID: 2567728652 Enrollment ID: I20171106001844 |
| Provider Name | Alexandra Kondratyeva |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659682003 PECOS PAC ID: 5597021550 Enrollment ID: I20171107001686 |
| Provider Name | Sandra Hanna |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1578042628 PECOS PAC ID: 5890048409 Enrollment ID: I20181030000183 |
| Provider Name | Katharine Buckley |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1184080673 PECOS PAC ID: 4183964901 Enrollment ID: I20190314000209 |
| Provider Name | Samuel J Knee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962768960 PECOS PAC ID: 6709178205 Enrollment ID: I20190522001996 |
| Provider Name | Imran Saeed |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1669501748 PECOS PAC ID: 1153495742 Enrollment ID: I20190802001910 |
| Provider Name | Sabah Kalyoussef |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1598089195 PECOS PAC ID: 8022147214 Enrollment ID: I20190923001632 |
| Provider Name | Minal Doshi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346506193 PECOS PAC ID: 6608112446 Enrollment ID: I20200212000583 |
| Provider Name | Lindsay Arthur |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184833519 PECOS PAC ID: 8224139753 Enrollment ID: I20211111002239 |
| Provider Name | Shana R Mencher |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1053706887 PECOS PAC ID: 0244620383 Enrollment ID: I20211206000447 |
| Provider Name | Divya Khurana |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1295039253 PECOS PAC ID: 4183949225 Enrollment ID: I20220425002760 |
| Provider Name | Beatrice A Zamfir |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1558021162 PECOS PAC ID: 6305203381 Enrollment ID: I20230607000115 |
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