| Senior Healthcare Outreach Program | |
|
613 Park Ave East Orange NJ 07017-1905 | |
| (973) 556-0955 | |
| (973) 675-0040 |
| Full Name | Senior Healthcare Outreach Program |
|---|---|
| Speciality | Internal Medicine |
| Location | 613 Park Ave, East Orange, New Jersey |
| Authorized Official Name and Position | Alexander G Salerno (OWNER) |
| Authorized Official Contact | 9736728573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Healthcare Outreach Program 346 Roseville Ave Newark NJ 07107-1722 Ph: (973) 556-0955 | Senior Healthcare Outreach Program 613 Park Ave East Orange NJ 07017-1905 Ph: (973) 556-0955 |
| NPI Number | 1588707954 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 02/03/2020 |
| Medicare PECOS PAC ID | 5890893713 |
|---|---|
| Medicare Enrollment ID | O20070531000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588707954 | NPI | - | NPPES |
| 0089273 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (New Jersey) | Primary |
| Provider Name | Alexander G Salerno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962476903 PECOS PAC ID: 3375455959 Enrollment ID: I20031105000696 |
| Provider Name | Roel P Galope |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629021779 PECOS PAC ID: 5991771974 Enrollment ID: I20060508000194 |
| Provider Name | Bela Laschiver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497896286 PECOS PAC ID: 7214030071 Enrollment ID: I20070315000198 |
| Provider Name | Nilay Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154372621 PECOS PAC ID: 5890704811 Enrollment ID: I20070816000577 |
| Provider Name | Kuang-yiao Hsieh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1114968260 PECOS PAC ID: 3678632825 Enrollment ID: I20081104000084 |
| Provider Name | Reginald J Denis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699984682 PECOS PAC ID: 6901905124 Enrollment ID: I20081110000638 |
| Provider Name | Maria Mercedes Cabodevilla Conn |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457465585 PECOS PAC ID: 6204816853 Enrollment ID: I20081210000016 |
| Provider Name | Kevin C Herman |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1619107703 PECOS PAC ID: 4082750591 Enrollment ID: I20091013000609 |
| Provider Name | Rakesh K Sahni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265636526 PECOS PAC ID: 4385537315 Enrollment ID: I20101124000090 |
| Provider Name | Mary Ellen E Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619915428 PECOS PAC ID: 9830370170 Enrollment ID: I20110221000394 |
| Provider Name | Aida L Ramos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255574307 PECOS PAC ID: 0042496457 Enrollment ID: I20110519000686 |
| Provider Name | Andrea C Fodor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851505663 PECOS PAC ID: 1254500275 Enrollment ID: I20110809000469 |
| Provider Name | Mershad Hagigi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700083763 PECOS PAC ID: 5991938177 Enrollment ID: I20140424001494 |
| Provider Name | Juanito E Savaille |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467885061 PECOS PAC ID: 9032330766 Enrollment ID: I20141022001955 |
| Provider Name | Rosemary Gorman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073910519 PECOS PAC ID: 6800112228 Enrollment ID: I20150303000329 |
| Provider Name | Ayme Veronica Frometa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669600995 PECOS PAC ID: 0941515720 Enrollment ID: I20150824000994 |
| Provider Name | Gordon D Lutchman |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1548270861 PECOS PAC ID: 5799843371 Enrollment ID: I20160223001215 |
| Provider Name | Elizabeth Doi Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710322730 PECOS PAC ID: 1850525973 Enrollment ID: I20160830000285 |
| Provider Name | Diana Rose Larrea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225460454 PECOS PAC ID: 3072809805 Enrollment ID: I20160906000096 |
| Provider Name | Michelle M Giles-honore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023416898 PECOS PAC ID: 9234427915 Enrollment ID: I20161012001949 |
| Provider Name | Maria Christina Errazo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932644812 PECOS PAC ID: 2365725801 Enrollment ID: I20170208001141 |
| Provider Name | Amanda A Marino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508240441 PECOS PAC ID: 7012284649 Enrollment ID: I20170601001609 |
| Provider Name | Edrik Josue Acevedo Beltran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427478353 PECOS PAC ID: 1850628371 Enrollment ID: I20190807000008 |
| Provider Name | Joanne Marmol Marmolejos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710240213 PECOS PAC ID: 7810239738 Enrollment ID: I20200311000548 |
| Provider Name | James B Friedlander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265932131 PECOS PAC ID: 7416359872 Enrollment ID: I20210708001336 |
| Provider Name | Iris Berangell Acosta Amezquita |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295482610 PECOS PAC ID: 0143616979 Enrollment ID: I20220405000049 |
| Provider Name | Jennifer M Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790412591 PECOS PAC ID: 4789068420 Enrollment ID: I20220908001464 |
| Provider Name | Isabel Leticia Mora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972167682 PECOS PAC ID: 9830574383 Enrollment ID: I20220920000040 |
| Provider Name | Cristian Serna-tamayo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396125381 PECOS PAC ID: 9739495573 Enrollment ID: I20230413000975 |
United Medical Associates Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 280 S Harrison St Suite 304, East Orange, NJ 07018 Phone: 862-438-8265 | |
Clinical Consulting Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 Central Ave, East Orange, NJ 07018 Phone: 973-417-6871 | |
Lianmed Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Central Ave, Suite 102, East Orange, NJ 07018 Phone: 201-512-9494 | |
East Orange Medical Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 S Munn Ave, East Orange, NJ 07018 Phone: 973-674-8100 Fax: 973-674-8400 | |
Orange Medical Group Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Central Ave, Suite 106, East Orange, NJ 07018 Phone: 973-674-4542 Fax: 973-674-3901 | |
A1 Medical Care Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 310 Central Ave, Suite 310, East Orange, NJ 07018 Phone: 973-678-2900 Fax: 973-678-8183 | |
Warren County Medical Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 613 Park Ave, 2nd Floor, East Orange, NJ 07017 Phone: 973-672-2455 Fax: 973-675-0040 |