| Saratoga Hospital | |
|
665 Saratoga Rd Gansevoort NY 12831-1599 | |
| (518) 886-5108 | |
| (518) 886-5857 |
| Full Name | Saratoga Hospital |
|---|---|
| Speciality | Internal Medicine |
| Location | 665 Saratoga Rd, Gansevoort, New York |
| Authorized Official Name and Position | Kathleen Stahura (DIRECTOR) |
| Authorized Official Contact | 5185838346 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saratoga Hospital Po Box 412655 Boston MA 02241-2655 Ph: () - | Saratoga Hospital 665 Saratoga Rd Gansevoort NY 12831-1599 Ph: (518) 886-5108 |
| NPI Number | 1033371166 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 04/01/2021 |
| Medicare PECOS PAC ID | 6406740273 |
|---|---|
| Medicare Enrollment ID | O20040402000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033371166 | NPI | - | NPPES |
| Provider Name | Kim P Gendron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053404061 PECOS PAC ID: 0042108920 Enrollment ID: I20040310001109 |
| Provider Name | Eliot L Birnbaum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609847995 PECOS PAC ID: 3971493602 Enrollment ID: I20040317000748 |
| Provider Name | Dorothy J Reynolds |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346276169 PECOS PAC ID: 2860383486 Enrollment ID: I20040323001092 |
| Provider Name | Kelly A Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255333258 PECOS PAC ID: 3274526330 Enrollment ID: I20040405001518 |
| Provider Name | Jenny Romero |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1245217553 PECOS PAC ID: 9335133453 Enrollment ID: I20040412001616 |
| Provider Name | Paul R Dittes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366481491 PECOS PAC ID: 4587651674 Enrollment ID: I20040429000914 |
| Provider Name | Tracie Di Marco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558354274 PECOS PAC ID: 9830170141 Enrollment ID: I20040525000065 |
| Provider Name | Wayne J Farnsworth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659430551 PECOS PAC ID: 5991788184 Enrollment ID: I20040609000950 |
| Provider Name | Lauris J Petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629152301 PECOS PAC ID: 0648254995 Enrollment ID: I20040617000227 |
| Provider Name | Christine A Alexander Decker |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1134117237 PECOS PAC ID: 6709864259 Enrollment ID: I20040710000339 |
| Provider Name | Timothy Brooks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841227758 PECOS PAC ID: 4082503206 Enrollment ID: I20040712001573 |
| Provider Name | William T Fisher |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184651093 PECOS PAC ID: 2860470903 Enrollment ID: I20040713001414 |
| Provider Name | Renee B Rodriguez-goodemote |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295761435 PECOS PAC ID: 2567437809 Enrollment ID: I20040830000874 |
| Provider Name | Anouk R Lambers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699732081 PECOS PAC ID: 8325015308 Enrollment ID: I20040910000816 |
| Provider Name | Kathleen M Lanka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548221914 PECOS PAC ID: 1850368762 Enrollment ID: I20040910001114 |
| Provider Name | Karie Deming |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740297548 PECOS PAC ID: 0648249979 Enrollment ID: I20041001000943 |
| Provider Name | Joshua D Zamer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144222597 PECOS PAC ID: 2860452950 Enrollment ID: I20041013000712 |
| Provider Name | Randall L Burchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407827462 PECOS PAC ID: 6002870300 Enrollment ID: I20041116001104 |
| Provider Name | Colette Blackington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881672079 PECOS PAC ID: 1951368794 Enrollment ID: I20041214000422 |
| Provider Name | Ephraim E Back |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649295254 PECOS PAC ID: 0547228009 Enrollment ID: I20041230000026 |
| Provider Name | Stephen R Offord |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114953312 PECOS PAC ID: 1153371224 Enrollment ID: I20050126000685 |
| Provider Name | Mary Beth D'aloia |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1366431629 PECOS PAC ID: 4486606688 Enrollment ID: I20050216000300 |
| Provider Name | Peter N F Van Der Riet |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1336103761 PECOS PAC ID: 2860444601 Enrollment ID: I20050221000166 |
| Provider Name | Jean Ansari Flanagan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396795118 PECOS PAC ID: 9234183344 Enrollment ID: I20050310000575 |
| Provider Name | Jamie Lyn Masson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962404871 PECOS PAC ID: 8729055801 Enrollment ID: I20050328000922 |
| Provider Name | Craig Roberts |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1881785913 PECOS PAC ID: 9931149440 Enrollment ID: I20050504000556 |
| Provider Name | Frederick D Reynolds |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164442711 PECOS PAC ID: 2466493747 Enrollment ID: I20050517000597 |
| Provider Name | Paul D Mullin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588682827 PECOS PAC ID: 8022050426 Enrollment ID: I20050525001113 |
| Provider Name | Bert W Pyle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023044229 PECOS PAC ID: 6608810650 Enrollment ID: I20050610000714 |
| Provider Name | Rick D Teetz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396733408 PECOS PAC ID: 3274569215 Enrollment ID: I20050712000402 |
| Provider Name | Karen K Michelena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962582262 PECOS PAC ID: 4082640610 Enrollment ID: I20050714000341 |
| Provider Name | Jason E Bernad |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932136843 PECOS PAC ID: 3072542992 Enrollment ID: I20050810000754 |
| Provider Name | Amy E Hogan Moulton |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730177825 PECOS PAC ID: 3072543610 Enrollment ID: I20050815000213 |
| Provider Name | Linda J Hill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902894090 PECOS PAC ID: 7719918614 Enrollment ID: I20050830000431 |
| Provider Name | Colleen T Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457436438 PECOS PAC ID: 0446284426 Enrollment ID: I20050920000203 |
| Provider Name | Cheryl Syta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982691481 PECOS PAC ID: 5597790881 Enrollment ID: I20051005000981 |
| Provider Name | Sarah J. Paris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144271552 PECOS PAC ID: 2163448549 Enrollment ID: I20051017000043 |
| Provider Name | Bernice Moeller Bloom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639173255 PECOS PAC ID: 2163448267 Enrollment ID: I20051018000941 |
| Provider Name | David J Koren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982639258 PECOS PAC ID: 7012933997 Enrollment ID: I20051020000112 |
| Provider Name | Carlos A Ares |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306870613 PECOS PAC ID: 0143240424 Enrollment ID: I20051201000319 |
| Provider Name | Malcolm Roth |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1598775884 PECOS PAC ID: 3779503974 Enrollment ID: I20051202000329 |
| Provider Name | Barry W Mitchell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124055439 PECOS PAC ID: 3678593621 Enrollment ID: I20051206000125 |
| Provider Name | Karin Md Borrelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023079431 PECOS PAC ID: 5294756359 Enrollment ID: I20051216000160 |
| Provider Name | Alexander Cardiel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629014279 PECOS PAC ID: 2961455597 Enrollment ID: I20060119000112 |
| Provider Name | Stanley Docyk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396781498 PECOS PAC ID: 7810960358 Enrollment ID: I20060310000068 |
| Provider Name | Patrick H Mcnulty |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881650109 PECOS PAC ID: 3072520105 Enrollment ID: I20060316000241 |
| Provider Name | Carl W Sgambati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811963937 PECOS PAC ID: 0648288787 Enrollment ID: I20060404000588 |
| Provider Name | Gordan Kuhar |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1750349379 PECOS PAC ID: 4385548635 Enrollment ID: I20060421000072 |
| Provider Name | Seth A Capello |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1346289626 PECOS PAC ID: 8628088853 Enrollment ID: I20060502000468 |
| Provider Name | Brian Yamada |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801849039 PECOS PAC ID: 7012900988 Enrollment ID: I20060810000036 |
| Provider Name | Ramez J Awwad |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1821030255 PECOS PAC ID: 9739183294 Enrollment ID: I20060914000389 |
| Provider Name | Margaret F Caiazza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609862978 PECOS PAC ID: 4880699792 Enrollment ID: I20060928000125 |
| Provider Name | Rachid Daoui |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1083608426 PECOS PAC ID: 9335145424 Enrollment ID: I20061012000528 |
| Provider Name | Todd Beyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003920810 PECOS PAC ID: 9133127632 Enrollment ID: I20061116000497 |
| Provider Name | Richard E Jones |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1043238181 PECOS PAC ID: 3678571833 Enrollment ID: I20061122000199 |
| Provider Name | Hung D Nguyen |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740395607 PECOS PAC ID: 3476553413 Enrollment ID: I20061222000054 |
| Provider Name | Sandra M Hermans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710909551 PECOS PAC ID: 8628079803 Enrollment ID: I20070131000333 |
| Provider Name | Amy B Eldredge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659491637 PECOS PAC ID: 6204932478 Enrollment ID: I20070504000039 |
| Provider Name | Benjamin S Katz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033137252 PECOS PAC ID: 0345346557 Enrollment ID: I20070504000360 |
| Provider Name | Joseph Hayes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447229646 PECOS PAC ID: 5294706602 Enrollment ID: I20070619000281 |
| Provider Name | Pedro I Ferrando Ross |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669556650 PECOS PAC ID: 1850492588 Enrollment ID: I20070725000603 |
| Provider Name | Johnna L Hawes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295861169 PECOS PAC ID: 4385735646 Enrollment ID: I20070801000470 |
| Provider Name | Diane Westbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952435505 PECOS PAC ID: 3971695990 Enrollment ID: I20070822001214 |
| Provider Name | Catherine M Dawson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659592616 PECOS PAC ID: 3577657600 Enrollment ID: I20070920000521 |
| Provider Name | Kathleen M Crisafulli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801824644 PECOS PAC ID: 4385739002 Enrollment ID: I20070926000740 |
| Provider Name | Lauren J Carignan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053514901 PECOS PAC ID: 5597850792 Enrollment ID: I20071003000292 |
| Provider Name | Christine Towers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609071091 PECOS PAC ID: 6204922099 Enrollment ID: I20071009000748 |
| Provider Name | Angela G Condy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366557720 PECOS PAC ID: 9032208152 Enrollment ID: I20071127000719 |
| Provider Name | Harold Card |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811965866 PECOS PAC ID: 9032004940 Enrollment ID: I20071207000118 |
| Provider Name | Roland Turner Phillips |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508834060 PECOS PAC ID: 6608965116 Enrollment ID: I20071207000238 |
| Provider Name | Theodoros Laddis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770551715 PECOS PAC ID: 0042309551 Enrollment ID: I20071207000250 |
| Provider Name | Kim E Schoch |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1346391604 PECOS PAC ID: 6507955804 Enrollment ID: I20071210000540 |
| Provider Name | Jonathan Berg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447244371 PECOS PAC ID: 9830289909 Enrollment ID: I20071213000580 |
| Provider Name | Andrij O Baran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962470724 PECOS PAC ID: 4486634813 Enrollment ID: I20071217000044 |
| Provider Name | Daniel J Eldredge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255520946 PECOS PAC ID: 5294815478 Enrollment ID: I20071228000382 |
| Provider Name | Shehzad Ali |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1578667218 PECOS PAC ID: 8325128895 Enrollment ID: I20080109000693 |
| Provider Name | Mikhail Mavashev |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275721797 PECOS PAC ID: 6305927906 Enrollment ID: I20080122000372 |
| Provider Name | Raveen Saluja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982694121 PECOS PAC ID: 9931281375 Enrollment ID: I20080124000404 |
| Provider Name | Robert P Nielson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073580627 PECOS PAC ID: 5890878482 Enrollment ID: I20080205000424 |
| Provider Name | Maureen Roberts |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295739621 PECOS PAC ID: 4183707896 Enrollment ID: I20080218000511 |
| Provider Name | Jennifer L White |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730304411 PECOS PAC ID: 4880779271 Enrollment ID: I20080310000379 |
| Provider Name | Pamela L Daly |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760466387 PECOS PAC ID: 1759467707 Enrollment ID: I20080401000062 |
| Provider Name | Robert J Halbig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447211057 PECOS PAC ID: 1658398623 Enrollment ID: I20080402000158 |
| Provider Name | John P Pezzulo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942261540 PECOS PAC ID: 7911924980 Enrollment ID: I20080407000034 |
| Provider Name | Christopher Case |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578599718 PECOS PAC ID: 5698728228 Enrollment ID: I20080408000591 |
| Provider Name | Martin K Weitzel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629189816 PECOS PAC ID: 5496833105 Enrollment ID: I20080422000275 |
| Provider Name | Ioliene Boenau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013943158 PECOS PAC ID: 5395648778 Enrollment ID: I20080505000647 |
| Provider Name | Maureen Rotondi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568641918 PECOS PAC ID: 9436228129 Enrollment ID: I20080521000395 |
| Provider Name | Mark H Weidner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972680288 PECOS PAC ID: 1658389598 Enrollment ID: I20080611000278 |
| Provider Name | Mohammad El-hajjar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073783577 PECOS PAC ID: 8921172123 Enrollment ID: I20080806000522 |
| Provider Name | Anthony Nappi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1457541583 PECOS PAC ID: 0547346835 Enrollment ID: I20080806000573 |
| Provider Name | Meredith M Degennaro |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1770752065 PECOS PAC ID: 6800960824 Enrollment ID: I20080808000156 |
| Provider Name | Joanne M Mcdonough |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467463414 PECOS PAC ID: 2860478385 Enrollment ID: I20080814000349 |
| Provider Name | Patrick Gerard Lynch |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1841495256 PECOS PAC ID: 4789759994 Enrollment ID: I20080822000613 |
| Provider Name | Rocco Grella |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689780819 PECOS PAC ID: 6406850049 Enrollment ID: I20080926000467 |
| Provider Name | Peter C Ferrera |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487626107 PECOS PAC ID: 2365466430 Enrollment ID: I20081111000089 |
| Provider Name | Daniel Collin Dorsey |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1285697128 PECOS PAC ID: 7719941152 Enrollment ID: I20081111000366 |
| Provider Name | Walter E Niedzwiadek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902887912 PECOS PAC ID: 4486715604 Enrollment ID: I20081206000015 |
| Provider Name | Russell Loeber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700804796 PECOS PAC ID: 9436154077 Enrollment ID: I20081211000486 |
| Provider Name | Todd D Duthaler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164467684 PECOS PAC ID: 4880647411 Enrollment ID: I20090115000212 |
| Provider Name | Enrique Yepes Hoyos |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073575007 PECOS PAC ID: 5395809446 Enrollment ID: I20090204000292 |
| Provider Name | Zachary H Passaretti |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1750357349 PECOS PAC ID: 2264597061 Enrollment ID: I20090306000302 |
| Provider Name | Bryan E Kurtz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790710069 PECOS PAC ID: 3870546401 Enrollment ID: I20090512000341 |
| Provider Name | Donald Sheeley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700951886 PECOS PAC ID: 1850449620 Enrollment ID: I20090520000527 |
| Provider Name | Kathleen A Murphy |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1104994235 PECOS PAC ID: 4688724362 Enrollment ID: I20090618000493 |
| Provider Name | Brian P Mcdermott |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1477707552 PECOS PAC ID: 5294886313 Enrollment ID: I20090701000509 |
| Provider Name | Mary H Constantino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710116488 PECOS PAC ID: 6305998337 Enrollment ID: I20090722000189 |
| Provider Name | Elizabeth M Spooner Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043444383 PECOS PAC ID: 9537213749 Enrollment ID: I20090821000143 |
| Provider Name | Qiong Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033146345 PECOS PAC ID: 7416900048 Enrollment ID: I20090901000081 |
| Provider Name | Stephen S Sgambati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366403172 PECOS PAC ID: 3577619311 Enrollment ID: I20090921000558 |
| Provider Name | John Mongan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134235765 PECOS PAC ID: 9234276130 Enrollment ID: I20091027000006 |
| Provider Name | Shannon Klingebiel |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1770735623 PECOS PAC ID: 2466447560 Enrollment ID: I20091207000100 |
| Provider Name | John Delmonte |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1043427586 PECOS PAC ID: 5597823138 Enrollment ID: I20091207000494 |
| Provider Name | Edward Liebers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174528764 PECOS PAC ID: 4880736990 Enrollment ID: I20100127000355 |
| Provider Name | Barbara Smith Foy |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1962427047 PECOS PAC ID: 7012098130 Enrollment ID: I20100211000007 |
| Provider Name | Mary Kay Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942241971 PECOS PAC ID: 7618010745 Enrollment ID: I20100211000258 |
| Provider Name | Elizabeth A Valentine |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1205823341 PECOS PAC ID: 6002950805 Enrollment ID: I20100217000414 |
| Provider Name | Kevin M Dooley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417945510 PECOS PAC ID: 9830085901 Enrollment ID: I20100220000053 |
| Provider Name | Nancy L Barraclough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255668109 PECOS PAC ID: 0143365148 Enrollment ID: I20100302000493 |
| Provider Name | Suzanne M Rayeski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700890654 PECOS PAC ID: 2466587118 Enrollment ID: I20100319000100 |
| Provider Name | David Mastrianni |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1417954264 PECOS PAC ID: 3173590445 Enrollment ID: I20100323000720 |
| Provider Name | Irene Flatau |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699783472 PECOS PAC ID: 9537296074 Enrollment ID: I20100415000030 |
| Provider Name | Dean A Reali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396759767 PECOS PAC ID: 2567590987 Enrollment ID: I20100505000881 |
| Provider Name | Rodney Ying |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1750309860 PECOS PAC ID: 1759316367 Enrollment ID: I20100507000090 |
| Provider Name | Janice L Ceccucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114249935 PECOS PAC ID: 1254469208 Enrollment ID: I20100512000351 |
| Provider Name | Christopher Buff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417918012 PECOS PAC ID: 5193742161 Enrollment ID: I20100602000271 |
| Provider Name | Audra Hanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588625271 PECOS PAC ID: 5092844951 Enrollment ID: I20100602000612 |
| Provider Name | Dmitri V Baranov |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548437296 PECOS PAC ID: 9133258940 Enrollment ID: I20100603000223 |
| Provider Name | Gordon M Ortiz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1023068640 PECOS PAC ID: 9032240114 Enrollment ID: I20100707000046 |
| Provider Name | Andrea Yolanda Carrasco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427023621 PECOS PAC ID: 9032242870 Enrollment ID: I20100730000839 |
| Provider Name | Susan M Muller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093701617 PECOS PAC ID: 6305960253 Enrollment ID: I20100828000144 |
| Provider Name | Michael J Skelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396780375 PECOS PAC ID: 5395869291 Enrollment ID: I20100830000536 |
| Provider Name | Carrie L Mcneil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053522268 PECOS PAC ID: 5698890598 Enrollment ID: I20100915001169 |
| Provider Name | Christine A Buhlinger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730145723 PECOS PAC ID: 8123144698 Enrollment ID: I20100922000593 |
| Provider Name | Brian Guadagno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922266261 PECOS PAC ID: 8820114697 Enrollment ID: I20100929000929 |
| Provider Name | Lorraine G Thibodeau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083600852 PECOS PAC ID: 1951593979 Enrollment ID: I20101008000981 |
| Provider Name | Paula R Curro-casey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740200773 PECOS PAC ID: 9335332477 Enrollment ID: I20101020001493 |
| Provider Name | Thomas John Francomano |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1922082742 PECOS PAC ID: 6204958408 Enrollment ID: I20101026000044 |
| Provider Name | Yoram Amsalem |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679702625 PECOS PAC ID: 4284828427 Enrollment ID: I20101101001191 |
| Provider Name | Mark Anthony Verra |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1245214063 PECOS PAC ID: 2365637840 Enrollment ID: I20101110000164 |
| Provider Name | Siobhan Hayden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598722977 PECOS PAC ID: 9830384197 Enrollment ID: I20101111001221 |
| Provider Name | Denis R Pauze |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811940299 PECOS PAC ID: 1456549377 Enrollment ID: I20101220000537 |
| Provider Name | Kathleen Huestis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255595641 PECOS PAC ID: 0143418871 Enrollment ID: I20101222000669 |
| Provider Name | Ayesha Sooriabalan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1134383904 PECOS PAC ID: 8123217379 Enrollment ID: I20110104000969 |
| Provider Name | Alexandr J Glozman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972591089 PECOS PAC ID: 8820277163 Enrollment ID: I20110119000714 |
| Provider Name | Joseph W Bell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679593222 PECOS PAC ID: 6002095049 Enrollment ID: I20110124000819 |
| Provider Name | Amos B Cutler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952300527 PECOS PAC ID: 4385833482 Enrollment ID: I20110210000993 |
| Provider Name | Amy E Knoeller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063411718 PECOS PAC ID: 9032023114 Enrollment ID: I20110210001148 |
| Provider Name | Jennifer Lefner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750304739 PECOS PAC ID: 0749460236 Enrollment ID: I20110216000384 |
| Provider Name | Eileen Santoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962589945 PECOS PAC ID: 7810178050 Enrollment ID: I20110222000633 |
| Provider Name | Judith Carr |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437144227 PECOS PAC ID: 8729269881 Enrollment ID: I20110222000886 |
| Provider Name | Kelly Goldenberg |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1275532947 PECOS PAC ID: 5395926463 Enrollment ID: I20110222001060 |
| Provider Name | Theresa A Jones Kingman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740289420 PECOS PAC ID: 5294917050 Enrollment ID: I20110315000874 |
| Provider Name | Victoria J Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770652323 PECOS PAC ID: 3870776032 Enrollment ID: I20110324000885 |
| Provider Name | Heather Madigan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033263553 PECOS PAC ID: 6608770250 Enrollment ID: I20110326000001 |
| Provider Name | Thomas Isenovski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326149535 PECOS PAC ID: 9537147517 Enrollment ID: I20110405001023 |
| Provider Name | John Davies |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205835220 PECOS PAC ID: 5890693857 Enrollment ID: I20110415000237 |
| Provider Name | Sheryl Salerno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306837950 PECOS PAC ID: 1355526674 Enrollment ID: I20110503000056 |
| Provider Name | Claudwardyne A Thevenin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407152937 PECOS PAC ID: 4082882311 Enrollment ID: I20110712000613 |
| Provider Name | Robert G Mchugh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710145982 PECOS PAC ID: 9931377835 Enrollment ID: I20110720000388 |
| Provider Name | Jennifer Fiorini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780981589 PECOS PAC ID: 5496925836 Enrollment ID: I20110823000396 |
| Provider Name | Claudia L Iantorno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861468126 PECOS PAC ID: 8628249919 Enrollment ID: I20110916000326 |
| Provider Name | Mary Kilayko |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841437258 PECOS PAC ID: 6204007537 Enrollment ID: I20110919000320 |
| Provider Name | Derek Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639279912 PECOS PAC ID: 5294750733 Enrollment ID: I20110921000021 |
| Provider Name | Anthony F Cutry |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336199512 PECOS PAC ID: 5092811570 Enrollment ID: I20110929000441 |
| Provider Name | Emily L Scialabba |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679854707 PECOS PAC ID: 9931372901 Enrollment ID: I20111108000303 |
| Provider Name | Elizabeth A Hutchins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144508144 PECOS PAC ID: 5395918379 Enrollment ID: I20111108000459 |
| Provider Name | Meghan Mj Promnitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699063495 PECOS PAC ID: 2961676606 Enrollment ID: I20111115000745 |
| Provider Name | Marianne A Mustafa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497841860 PECOS PAC ID: 8325097793 Enrollment ID: I20111121000637 |
| Provider Name | Robert Donnarumma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295051951 PECOS PAC ID: 1254507734 Enrollment ID: I20120104000846 |
| Provider Name | Robert W Hahm |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538234778 PECOS PAC ID: 5890952758 Enrollment ID: I20120203000303 |
| Provider Name | Susan A Mcdermott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093088247 PECOS PAC ID: 1254592413 Enrollment ID: I20120416000037 |
| Provider Name | Alfred M Loka |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1427257500 PECOS PAC ID: 9335327683 Enrollment ID: I20120705000398 |
| Provider Name | Jennifer L Borden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407842750 PECOS PAC ID: 9436244720 Enrollment ID: I20120809000540 |
| Provider Name | Eric C Borden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073562187 PECOS PAC ID: 9830095314 Enrollment ID: I20120814000077 |
| Provider Name | Jennifer P Beller |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1629280896 PECOS PAC ID: 3173770591 Enrollment ID: I20120820000955 |
| Provider Name | Numan T Rashid |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316106818 PECOS PAC ID: 7315194792 Enrollment ID: I20120821000433 |
| Provider Name | Richard Monroe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316106891 PECOS PAC ID: 9133376148 Enrollment ID: I20120827000669 |
| Provider Name | Angela R Memmelaar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336496025 PECOS PAC ID: 4981853983 Enrollment ID: I20121008000548 |
| Provider Name | Xiao Su |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1659505774 PECOS PAC ID: 8628228087 Enrollment ID: I20121019000147 |
| Provider Name | Romel H Gobunsuy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649415548 PECOS PAC ID: 2466602644 Enrollment ID: I20121024000433 |
| Provider Name | James R Caracci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659608057 PECOS PAC ID: 5092969097 Enrollment ID: I20130128000458 |
| Provider Name | Catherine Chincola |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740548049 PECOS PAC ID: 4981867389 Enrollment ID: I20130620000252 |
| Provider Name | Randall M Kimball |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972763977 PECOS PAC ID: 1557526720 Enrollment ID: I20130829000633 |
| Provider Name | Claudina S Ashelman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811082829 PECOS PAC ID: 5799912648 Enrollment ID: I20131220001071 |
| Provider Name | Rebecca S Bednarek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518113380 PECOS PAC ID: 9234367509 Enrollment ID: I20140113000568 |
| Provider Name | Richard E Lagace |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063702983 PECOS PAC ID: 6901035666 Enrollment ID: I20140130000053 |
| Provider Name | Donna M Cohen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265583926 PECOS PAC ID: 2668362872 Enrollment ID: I20140205000087 |
| Provider Name | Jodi L Falardeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811254667 PECOS PAC ID: 2668601980 Enrollment ID: I20140208000288 |
| Provider Name | Susan Bradford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639311707 PECOS PAC ID: 2062641046 Enrollment ID: I20140218000159 |
| Provider Name | Ali Jennifer Doyle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043444581 PECOS PAC ID: 4688805534 Enrollment ID: I20140318001932 |
| Provider Name | Warren C Litts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144292608 PECOS PAC ID: 1456318393 Enrollment ID: I20140418000297 |
| Provider Name | Shumaila I Khan |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1821224445 PECOS PAC ID: 4082846340 Enrollment ID: I20140421000868 |
| Provider Name | Enrico A Bravo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639497365 PECOS PAC ID: 9032342118 Enrollment ID: I20140424001647 |
| Provider Name | Janice M Mattson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811315054 PECOS PAC ID: 8325262280 Enrollment ID: I20140616000706 |
| Provider Name | Claudianus H Bourne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851646541 PECOS PAC ID: 7810111515 Enrollment ID: I20140620000114 |
| Provider Name | Hope G Raggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932536356 PECOS PAC ID: 4183849466 Enrollment ID: I20140630000035 |
| Provider Name | Nicoleta Daraban |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538353008 PECOS PAC ID: 8820186349 Enrollment ID: I20140703001196 |
| Provider Name | Christina Goldsmith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821377813 PECOS PAC ID: 6709003403 Enrollment ID: I20140804000486 |
| Provider Name | Scott W Newton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467771444 PECOS PAC ID: 4082831599 Enrollment ID: I20140806002599 |
| Provider Name | Gabriel Radu |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1376861765 PECOS PAC ID: 5395962492 Enrollment ID: I20140813002739 |
| Provider Name | Jean R Mischler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003221391 PECOS PAC ID: 3476772922 Enrollment ID: I20140915001790 |
| Provider Name | Pamela A Casey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831598051 PECOS PAC ID: 6709006984 Enrollment ID: I20141010001248 |
| Provider Name | Eric R Santell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801219605 PECOS PAC ID: 6901027077 Enrollment ID: I20141015001435 |
| Provider Name | Ashley R Telisky |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205194214 PECOS PAC ID: 9436370319 Enrollment ID: I20141017000266 |
| Provider Name | Nina Grace Bradley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750692422 PECOS PAC ID: 6709025505 Enrollment ID: I20141027001235 |
| Provider Name | Lee C Ruotsi |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1376504605 PECOS PAC ID: 3274512009 Enrollment ID: I20141120001730 |
| Provider Name | Michael W Holley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548666969 PECOS PAC ID: 0143545418 Enrollment ID: I20150207000238 |
| Provider Name | Erin Ann Winter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801952379 PECOS PAC ID: 8325140718 Enrollment ID: I20150213000050 |
| Provider Name | Jessica Taylor Potter |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1326446170 PECOS PAC ID: 7012233141 Enrollment ID: I20150306001462 |
| Provider Name | Rebecca Hegel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437558301 PECOS PAC ID: 8921325408 Enrollment ID: I20150320001556 |
| Provider Name | Yulia A Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295138238 PECOS PAC ID: 2163749292 Enrollment ID: I20150328000013 |
| Provider Name | Jeannene Fritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144636622 PECOS PAC ID: 5890012785 Enrollment ID: I20150403000221 |
| Provider Name | Dedra M Flynn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598754012 PECOS PAC ID: 5698771293 Enrollment ID: I20150507001632 |
| Provider Name | David Hindson |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1477781011 PECOS PAC ID: 4587896139 Enrollment ID: I20150721002030 |
| Provider Name | Stephen M Perazzelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295092237 PECOS PAC ID: 5597079384 Enrollment ID: I20150807013310 |
| Provider Name | Patricia R Kennedy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861450439 PECOS PAC ID: 0244274538 Enrollment ID: I20150831000225 |
| Provider Name | Emily Marie O'connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710368865 PECOS PAC ID: 7517275365 Enrollment ID: I20150929001053 |
| Provider Name | Jennifer Kittell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1134476492 PECOS PAC ID: 0143538504 Enrollment ID: I20151005000965 |
| Provider Name | Dara Kathleen Kelly |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1386010056 PECOS PAC ID: 0547578700 Enrollment ID: I20151007003244 |
| Provider Name | Rino Alberto Buzzola |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1730451287 PECOS PAC ID: 3577798560 Enrollment ID: I20151014000822 |
| Provider Name | Kimberly E Clemente |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912172917 PECOS PAC ID: 4688867476 Enrollment ID: I20151124002438 |
| Provider Name | Kathleen Cornell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801265947 PECOS PAC ID: 4688976954 Enrollment ID: I20160104000407 |
| Provider Name | Timothy R Waters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083813885 PECOS PAC ID: 9638326556 Enrollment ID: I20160107002485 |
| Provider Name | Maria Vivenzio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356600670 PECOS PAC ID: 2769784776 Enrollment ID: I20160107002865 |
| Provider Name | Sara E Gorham |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1932177631 PECOS PAC ID: 5597918235 Enrollment ID: I20160204001080 |
| Provider Name | Zeshan Latif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447504378 PECOS PAC ID: 6305140773 Enrollment ID: I20160204001183 |
| Provider Name | Deanna M Veet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366822314 PECOS PAC ID: 4981908365 Enrollment ID: I20160204001414 |
| Provider Name | Laura S Mcmahon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003834888 PECOS PAC ID: 0446143812 Enrollment ID: I20160211002120 |
| Provider Name | Kathy Rittenhouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043624737 PECOS PAC ID: 7012213812 Enrollment ID: I20160303002257 |
| Provider Name | Sarah R Stacey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053795781 PECOS PAC ID: 8224337241 Enrollment ID: I20160426001326 |
| Provider Name | Nicole M Gehman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1164899860 PECOS PAC ID: 8921397589 Enrollment ID: I20160520000880 |
| Provider Name | Stephen G Verdini |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538588090 PECOS PAC ID: 2860784295 Enrollment ID: I20160706000279 |
| Provider Name | Yasmin Z Mohamed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699111203 PECOS PAC ID: 6901199975 Enrollment ID: I20160728000757 |
| Provider Name | Jodi A Tamburrino |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1447646328 PECOS PAC ID: 8224322987 Enrollment ID: I20160803002697 |
| Provider Name | Megan K Applewhite |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043449317 PECOS PAC ID: 7911204698 Enrollment ID: I20160823000892 |
| Provider Name | Lindsay C Ferraro |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194003889 PECOS PAC ID: 0446545628 Enrollment ID: I20160826001677 |
| Provider Name | Christopher Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851767420 PECOS PAC ID: 0648565671 Enrollment ID: I20160830000061 |
| Provider Name | Amanda L Dow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407115470 PECOS PAC ID: 5496041162 Enrollment ID: I20160906001815 |
| Provider Name | Stacy L. Mchale-mcbain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538519004 PECOS PAC ID: 6305133034 Enrollment ID: I20160923001737 |
| Provider Name | Jennifer A Denis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104103712 PECOS PAC ID: 3870880230 Enrollment ID: I20160928002046 |
| Provider Name | Shane Diamond |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528403698 PECOS PAC ID: 8527294453 Enrollment ID: I20161012002921 |
| Provider Name | Laura R Newey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083073373 PECOS PAC ID: 4688953136 Enrollment ID: I20161128001504 |
| Provider Name | Meaghan A Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245789783 PECOS PAC ID: 3274813548 Enrollment ID: I20161201002046 |
| Provider Name | Rachel Mackenzie Lemos |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760835045 PECOS PAC ID: 1456631431 Enrollment ID: I20161208001666 |
| Provider Name | Eunyoung Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912455890 PECOS PAC ID: 6608157623 Enrollment ID: I20170106000705 |
| Provider Name | Rebecca B Mahar |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548380132 PECOS PAC ID: 6204117922 Enrollment ID: I20170111001332 |
| Provider Name | Pao-ching Tung |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629510946 PECOS PAC ID: 5193007862 Enrollment ID: I20170113000911 |
| Provider Name | Erica J Masterson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144764630 PECOS PAC ID: 4981986130 Enrollment ID: I20170123002229 |
| Provider Name | Lindsay Kennedy |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1912452699 PECOS PAC ID: 0345523924 Enrollment ID: I20170206000172 |
| Provider Name | Young K Elinskas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194027300 PECOS PAC ID: 6305129248 Enrollment ID: I20170220001316 |
| Provider Name | Stacey M Flenory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942758610 PECOS PAC ID: 9931484557 Enrollment ID: I20170322002347 |
| Provider Name | Haiyang Tao |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1609100098 PECOS PAC ID: 3678731270 Enrollment ID: I20170410001436 |
| Provider Name | Mohamed Khalid Munshi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1174841035 PECOS PAC ID: 7214214667 Enrollment ID: I20170512000167 |
| Provider Name | Jacqueline L Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053520650 PECOS PAC ID: 3072659648 Enrollment ID: I20170512000768 |
| Provider Name | Timothy J Palmieri |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821408048 PECOS PAC ID: 6709153166 Enrollment ID: I20170606002866 |
| Provider Name | Rachael Jones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417256868 PECOS PAC ID: 8527358506 Enrollment ID: I20170714000884 |
| Provider Name | Catherine Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871023200 PECOS PAC ID: 3779853833 Enrollment ID: I20170721001984 |
| Provider Name | Rosann Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285087320 PECOS PAC ID: 8820379399 Enrollment ID: I20170801000683 |
| Provider Name | Katie M Leahy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1881050599 PECOS PAC ID: 4284905100 Enrollment ID: I20170810001086 |
| Provider Name | Talara Hedgpeth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346779873 PECOS PAC ID: 1951673862 Enrollment ID: I20170826000319 |
| Provider Name | Leticia R Daconti |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821417213 PECOS PAC ID: 4880815802 Enrollment ID: I20170913000517 |
| Provider Name | Arlene R Law |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104371632 PECOS PAC ID: 1850670365 Enrollment ID: I20170920001912 |
| Provider Name | Paul Haley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295724755 PECOS PAC ID: 4385623131 Enrollment ID: I20171116000818 |
| Provider Name | Iris E Gonzalo-sowle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154783439 PECOS PAC ID: 2365701042 Enrollment ID: I20180126000497 |
| Provider Name | Sean Peter Fuster |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1982113809 PECOS PAC ID: 2567722788 Enrollment ID: I20180208002085 |
| Provider Name | Sergio M Lema-gutierrez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538435912 PECOS PAC ID: 9931350907 Enrollment ID: I20180208002215 |
| Provider Name | Jessica R Nelson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255730552 PECOS PAC ID: 0749401354 Enrollment ID: I20180212002383 |
| Provider Name | Janice Prichett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447321369 PECOS PAC ID: 3678835238 Enrollment ID: I20180319001137 |
| Provider Name | Erin E Juliano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225067853 PECOS PAC ID: 5395778443 Enrollment ID: I20180327000420 |
| Provider Name | Karen Lynne Zanni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255714069 PECOS PAC ID: 9436411667 Enrollment ID: I20180327002297 |
| Provider Name | Jeanne Marie Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619477171 PECOS PAC ID: 4981968781 Enrollment ID: I20180502002231 |
| Provider Name | Maleah M Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285131003 PECOS PAC ID: 0648534065 Enrollment ID: I20180510000711 |
| Provider Name | Dana Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750884805 PECOS PAC ID: 1153686274 Enrollment ID: I20180521000580 |
| Provider Name | James E Corwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144225442 PECOS PAC ID: 3870506900 Enrollment ID: I20180608000373 |
| Provider Name | Casian J Monaco |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1033409420 PECOS PAC ID: 7012289556 Enrollment ID: I20180625002858 |
| Provider Name | Daniel R Reilly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053516138 PECOS PAC ID: 5496903841 Enrollment ID: I20180712001214 |
| Provider Name | Amanda Bernard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922590348 PECOS PAC ID: 9335497890 Enrollment ID: I20180731003707 |
| Provider Name | Mridula A Jacob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023491701 PECOS PAC ID: 6507116324 Enrollment ID: I20180829000449 |
| Provider Name | Stephanie Susan Verleger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194043265 PECOS PAC ID: 8426358250 Enrollment ID: I20181009001129 |
| Provider Name | Timothy P Reed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699098806 PECOS PAC ID: 0143449876 Enrollment ID: I20181022002601 |
| Provider Name | James Fitzhugh Kelley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770902421 PECOS PAC ID: 6002199585 Enrollment ID: I20181101000617 |
| Provider Name | Brandy L Wadsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881186930 PECOS PAC ID: 3173876570 Enrollment ID: I20181101002198 |
| Provider Name | Jansi Gnanasekaran |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760825103 PECOS PAC ID: 6103110317 Enrollment ID: I20181106000636 |
| Provider Name | Wendy A Randall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982183463 PECOS PAC ID: 9537413208 Enrollment ID: I20181115001084 |
| Provider Name | Jolene M Kent Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952581902 PECOS PAC ID: 9931453545 Enrollment ID: I20181119001200 |
| Provider Name | Karen E Krutchick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457795452 PECOS PAC ID: 0143529420 Enrollment ID: I20190108003342 |
| Provider Name | Shannon James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053898908 PECOS PAC ID: 3173869898 Enrollment ID: I20190116002205 |
| Provider Name | Sara Posdzich |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821563479 PECOS PAC ID: 7012254675 Enrollment ID: I20190122000506 |
| Provider Name | Devjit Roy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891058996 PECOS PAC ID: 5890918882 Enrollment ID: I20190123002886 |
| Provider Name | Katie M Gregg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033586904 PECOS PAC ID: 1557656774 Enrollment ID: I20190304000864 |
| Provider Name | Kristen W Sergott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760562375 PECOS PAC ID: 6507106424 Enrollment ID: I20190312003174 |
| Provider Name | Kendra E Kline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437638236 PECOS PAC ID: 1052651809 Enrollment ID: I20190314001185 |
| Provider Name | Stephanie L Samascott |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1750853065 PECOS PAC ID: 2961742499 Enrollment ID: I20190320001998 |
| Provider Name | Courtney Caralynn Paton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982169991 PECOS PAC ID: 6507106929 Enrollment ID: I20190321002745 |
| Provider Name | Mallory B Otto |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1124317532 PECOS PAC ID: 0941514384 Enrollment ID: I20190531000238 |
| Provider Name | Riju Banerjee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417343674 PECOS PAC ID: 1850638107 Enrollment ID: I20190603001570 |
| Provider Name | Megan E Farrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083139612 PECOS PAC ID: 8426381518 Enrollment ID: I20190604002749 |
| Provider Name | Brandon James Otto |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1346483443 PECOS PAC ID: 3274845276 Enrollment ID: I20190606002425 |
| Provider Name | Sean P Boyle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821434135 PECOS PAC ID: 3779820162 Enrollment ID: I20190723000512 |
| Provider Name | Lindsay M Lachant |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649604331 PECOS PAC ID: 8820325202 Enrollment ID: I20190807002905 |
| Provider Name | Zachary M Novakovic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891145744 PECOS PAC ID: 2567791304 Enrollment ID: I20190904002085 |
| Provider Name | Bethany A Hawke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003348582 PECOS PAC ID: 5193062735 Enrollment ID: I20190917001834 |
| Provider Name | Amina Mookshah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174928758 PECOS PAC ID: 9931466554 Enrollment ID: I20190917002681 |
| Provider Name | Julie A Washington |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1578119202 PECOS PAC ID: 7012247943 Enrollment ID: I20190919001144 |
| Provider Name | Panakkal David |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942271937 PECOS PAC ID: 4688905102 Enrollment ID: I20191015002542 |
| Provider Name | Rachel Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932757531 PECOS PAC ID: 2961734132 Enrollment ID: I20191022000756 |
| Provider Name | Casey N Moore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154856862 PECOS PAC ID: 3678810298 Enrollment ID: I20191029002988 |
| Provider Name | Disha N Mookherjee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225295108 PECOS PAC ID: 0345394714 Enrollment ID: I20191111002452 |
| Provider Name | June Brouillard Barber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023660792 PECOS PAC ID: 9436581204 Enrollment ID: I20191115001887 |
| Provider Name | Cathy A Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457900722 PECOS PAC ID: 3779916762 Enrollment ID: I20191205000790 |
| Provider Name | Elizabeth Bogovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578115432 PECOS PAC ID: 5193158905 Enrollment ID: I20191210000928 |
| Provider Name | Heather M Kidd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720440977 PECOS PAC ID: 6507292968 Enrollment ID: I20200203000750 |
| Provider Name | Thomas M Castaneda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417489808 PECOS PAC ID: 3870838816 Enrollment ID: I20200229000031 |
| Provider Name | Colleen Tillson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790264000 PECOS PAC ID: 8628407236 Enrollment ID: I20200402002177 |
| Provider Name | Ashley Willson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679843643 PECOS PAC ID: 0547690117 Enrollment ID: I20200422001276 |
| Provider Name | Joelle Malinowski |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1932735396 PECOS PAC ID: 7810327442 Enrollment ID: I20200522001144 |
| Provider Name | Anjan Marella |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871025007 PECOS PAC ID: 7113263880 Enrollment ID: I20200915000269 |
| Provider Name | Jaime Lynne Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205449600 PECOS PAC ID: 4688094345 Enrollment ID: I20201019001054 |
| Provider Name | Lorelei Natasha Bourla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144649260 PECOS PAC ID: 3678868221 Enrollment ID: I20201104001724 |
| Provider Name | Catelyn A Halusic-smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427439017 PECOS PAC ID: 6800148271 Enrollment ID: I20201112003185 |
| Provider Name | Keir Neighmond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700821824 PECOS PAC ID: 6305896978 Enrollment ID: I20201116001138 |
| Provider Name | Abigail A Neighmond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306839402 PECOS PAC ID: 5092719716 Enrollment ID: I20201117003372 |
| Provider Name | Michael Bourla |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417376013 PECOS PAC ID: 8426343252 Enrollment ID: I20201202002795 |
| Provider Name | Betsy V Rajan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326695917 PECOS PAC ID: 1355753989 Enrollment ID: I20201223001239 |
| Provider Name | Sidharth Jogani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912210444 PECOS PAC ID: 6800180480 Enrollment ID: I20201223001949 |
| Provider Name | Humaira Jami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336403195 PECOS PAC ID: 1850605957 Enrollment ID: I20210125001139 |
| Provider Name | Zachary Criswell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1023429651 PECOS PAC ID: 9234402736 Enrollment ID: I20210128000692 |
| Provider Name | Aaron Willen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316352776 PECOS PAC ID: 6002132214 Enrollment ID: I20210208001278 |
| Provider Name | Christina Georgia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427452846 PECOS PAC ID: 5395151435 Enrollment ID: I20210315002482 |
| Provider Name | Elizabeth O'hagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881166536 PECOS PAC ID: 6608208152 Enrollment ID: I20210412001851 |
| Provider Name | Jessica Haag |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1538497821 PECOS PAC ID: 0840483590 Enrollment ID: I20210421001312 |
| Provider Name | Jenny Brandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538774500 PECOS PAC ID: 8820406234 Enrollment ID: I20210426000376 |
| Provider Name | Jessica M Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760778625 PECOS PAC ID: 4688073604 Enrollment ID: I20210525000966 |
| Provider Name | Kathrin Lafaver |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528188836 PECOS PAC ID: 6204901952 Enrollment ID: I20210804000880 |
| Provider Name | Santosh D Vaghela |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1699186718 PECOS PAC ID: 8123377140 Enrollment ID: I20210804001272 |
| Provider Name | Hannah Dodge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861984064 PECOS PAC ID: 8325473044 Enrollment ID: I20210809002133 |
| Provider Name | David Mobarek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114411717 PECOS PAC ID: 6305240680 Enrollment ID: I20210809002528 |
| Provider Name | Alex Trolenberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437654720 PECOS PAC ID: 4587901814 Enrollment ID: I20210811000825 |
| Provider Name | Martha L Vanyo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588239289 PECOS PAC ID: 1658775721 Enrollment ID: I20210811002577 |
| Provider Name | Meghan Monthie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225533540 PECOS PAC ID: 1153725114 Enrollment ID: I20210812002514 |
| Provider Name | Katherine Evanico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033794821 PECOS PAC ID: 7012312424 Enrollment ID: I20210824001085 |
| Provider Name | Vincent Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215600960 PECOS PAC ID: 1658776737 Enrollment ID: I20210827001432 |
| Provider Name | Bernard Possidente |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912490038 PECOS PAC ID: 0446656789 Enrollment ID: I20210910002431 |
| Provider Name | Donna E Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396759882 PECOS PAC ID: 7113945189 Enrollment ID: I20210910002461 |
| Provider Name | Anna Bellinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023683471 PECOS PAC ID: 0941606180 Enrollment ID: I20210914000116 |
| Provider Name | Jennifer A Bayron |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376956532 PECOS PAC ID: 0143533653 Enrollment ID: I20210915002508 |
| Provider Name | Elizabeth Johnstone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649756669 PECOS PAC ID: 0749688356 Enrollment ID: I20211013000352 |
| Provider Name | Shapir Rosenberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063828473 PECOS PAC ID: 4082909379 Enrollment ID: I20211019001171 |
| Provider Name | Oluwatoyin Damilola Balogun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205321387 PECOS PAC ID: 1557759347 Enrollment ID: I20211027002932 |
| Provider Name | Joshua Enrique Bu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982375135 PECOS PAC ID: 2567850241 Enrollment ID: I20211029000378 |
| Provider Name | Penny Sue Warrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649562828 PECOS PAC ID: 7012301302 Enrollment ID: I20220302002455 |
| Provider Name | Matthew Stringer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437470804 PECOS PAC ID: 3870725138 Enrollment ID: I20220406000270 |
| Provider Name | Kathleen Allden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770651952 PECOS PAC ID: 9830148774 Enrollment ID: I20220412001342 |
| Provider Name | Rebecca Lynn Darragh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316454051 PECOS PAC ID: 0446512776 Enrollment ID: I20220523001561 |
| Provider Name | Rishi Malik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063975522 PECOS PAC ID: 3870823925 Enrollment ID: I20220712001023 |
| Provider Name | Richard P Falivena |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154578227 PECOS PAC ID: 3577616564 Enrollment ID: I20220724000020 |
| Provider Name | Megan Lieb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861953770 PECOS PAC ID: 3274866439 Enrollment ID: I20220808000499 |
| Provider Name | Samantha Blanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629717384 PECOS PAC ID: 4789066754 Enrollment ID: I20220808002101 |
| Provider Name | Kelvin Omonzane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942716469 PECOS PAC ID: 0446633374 Enrollment ID: I20220810001522 |
| Provider Name | Abigail M Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003551128 PECOS PAC ID: 5193108702 Enrollment ID: I20220815002374 |
| Provider Name | Leah Lafrance |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235800566 PECOS PAC ID: 6709261597 Enrollment ID: I20220914003013 |
| Provider Name | Vincent Seeger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477803658 PECOS PAC ID: 3173909355 Enrollment ID: I20220927000718 |
| Provider Name | Vincent Cousineau Cote |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578124640 PECOS PAC ID: 0446585574 Enrollment ID: I20220927002423 |
| Provider Name | Juliann Lajoie |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1245735059 PECOS PAC ID: 4880939727 Enrollment ID: I20221013002093 |
| Provider Name | Sarah Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083348916 PECOS PAC ID: 7719353796 Enrollment ID: I20221017000284 |
| Provider Name | Jolanta Maria Gurdek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205910098 PECOS PAC ID: 9830375591 Enrollment ID: I20221018002798 |
| Provider Name | Karen Hu |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1043745151 PECOS PAC ID: 0547504854 Enrollment ID: I20221027001229 |
| Provider Name | Cara L Kilroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659611713 PECOS PAC ID: 9335389543 Enrollment ID: I20221104002412 |
| Provider Name | Mark H Chalmers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033775283 PECOS PAC ID: 9537592191 Enrollment ID: I20221205002575 |
| Provider Name | Tiffany Haven Trovato |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1144937319 PECOS PAC ID: 9436529773 Enrollment ID: I20230103002163 |
| Provider Name | Luz Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164154803 PECOS PAC ID: 2860862802 Enrollment ID: I20230109000075 |
| Provider Name | Arthur Strzepka |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821625625 PECOS PAC ID: 0648635433 Enrollment ID: I20230501001219 |
| Provider Name | Srikanth Mitta |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1447316708 PECOS PAC ID: 2668525189 Enrollment ID: I20230630000658 |
| Provider Name | Amanda Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487359600 PECOS PAC ID: 6103285341 Enrollment ID: I20230706000236 |
| Provider Name | Terence Meehan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689297749 PECOS PAC ID: 7810356979 Enrollment ID: I20230707000386 |
| Provider Name | Adam Geoffrey Mace |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1316264732 PECOS PAC ID: 5698078582 Enrollment ID: I20230713000147 |
| Provider Name | Alicia Farrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750074118 PECOS PAC ID: 9133581028 Enrollment ID: I20230809001221 |
| Provider Name | Jennifer L Lue |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1649776329 PECOS PAC ID: 9436552015 Enrollment ID: I20230811000578 |
| Provider Name | Karen Tallon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568155604 PECOS PAC ID: 6800258955 Enrollment ID: I20230822000736 |
| Provider Name | Romel Persaud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770106833 PECOS PAC ID: 1951764257 Enrollment ID: I20230905002098 |
| Provider Name | Nicole Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174987432 PECOS PAC ID: 1658725080 Enrollment ID: I20231003003034 |
| Provider Name | Rhiannon Rogers Schin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386321305 PECOS PAC ID: 9638523004 Enrollment ID: I20231004000813 |
| Provider Name | Katelyn Mcgowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902587835 PECOS PAC ID: 6608223581 Enrollment ID: I20231115000259 |
| Provider Name | Aimee Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407639321 PECOS PAC ID: 8820446479 Enrollment ID: I20231121001557 |
| Provider Name | Emma Sanborn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609354059 PECOS PAC ID: 0547604548 Enrollment ID: I20240219000108 |
| Provider Name | Kadeeja Fredankey-parzych |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225651383 PECOS PAC ID: 5991141103 Enrollment ID: I20240311002095 |
| Provider Name | Nicole Vainauskas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487429692 PECOS PAC ID: 9931546611 Enrollment ID: I20240318003432 |
| Provider Name | Andres Crane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790244549 PECOS PAC ID: 2769719368 Enrollment ID: I20240415000977 |
| Provider Name | Suzanna Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477335438 PECOS PAC ID: 6103267760 Enrollment ID: I20240514001194 |
Hudson Headwaters Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1299 Route 9, Gansevoort, NY 12831 Phone: 518-761-6961 Fax: 518-761-1006 | |
Saratoga Women's Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 665 Saratoga Rd Ste 100, Gansevoort, NY 12831 Phone: 518-363-8815 Fax: 518-363-8831 |