| Slocum Dickson Medical Group Pllc | |
|
1729 Burrstone Rd New Hartford NY 13413-1001 | |
| (315) 798-1700 | |
| (315) 798-1707 |
| Full Name | Slocum Dickson Medical Group Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1729 Burrstone Rd, New Hartford, New York |
| Authorized Official Name and Position | Stephen D. Eadline (PRESIDENT) |
| Authorized Official Contact | 3157981700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Slocum Dickson Medical Group Pllc 1729 Burrstone Rd New Hartford NY 13413-1001 Ph: (315) 798-1700 | Slocum Dickson Medical Group Pllc 1729 Burrstone Rd New Hartford NY 13413-1001 Ph: (315) 798-1700 |
| NPI Number | 1285625996 |
|---|---|
| Provider Enumeration Date | 11/02/2005 |
| Last Update Date | 06/11/2021 |
| Medicare PECOS PAC ID | 5799778510 |
|---|---|
| Medicare Enrollment ID | O20040407000427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285625996 | NPI | - | NPPES |
| 02995013 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 47440 (New York) | Primary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Secondary |
| Provider Name | Ivan Antonevich |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1043256118 PECOS PAC ID: 6709778392 Enrollment ID: I20040329000106 |
| Provider Name | Christopher M Alinea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538162789 PECOS PAC ID: 2567367881 Enrollment ID: I20040414000454 |
| Provider Name | Jameel H Arastu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417944638 PECOS PAC ID: 7315842648 Enrollment ID: I20040414000822 |
| Provider Name | Bonnie M Casanova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700873858 PECOS PAC ID: 2567457989 Enrollment ID: I20040415001310 |
| Provider Name | James F Cesare |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386637015 PECOS PAC ID: 5991600231 Enrollment ID: I20040416000313 |
| Provider Name | Michelle L Chambrone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295728939 PECOS PAC ID: 0446245724 Enrollment ID: I20040416000508 |
| Provider Name | Kathleen W Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720075724 PECOS PAC ID: 4880689041 Enrollment ID: I20040416001213 |
| Provider Name | Pourushasp J Dhabhar |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1780678995 PECOS PAC ID: 0446155782 Enrollment ID: I20040417000050 |
| Provider Name | Ute H Dreiner |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1114914421 PECOS PAC ID: 4981509221 Enrollment ID: I20040417000079 |
| Provider Name | Stephen D Eadline |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053303453 PECOS PAC ID: 7618872953 Enrollment ID: I20040417000124 |
| Provider Name | Maria Barbara Gesualdo |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407840614 PECOS PAC ID: 2466447529 Enrollment ID: I20040417000450 |
| Provider Name | Daniel C Goodman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780678896 PECOS PAC ID: 0345145686 Enrollment ID: I20040419000509 |
| Provider Name | Celesta M Hunsiker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043204258 PECOS PAC ID: 1658366505 Enrollment ID: I20040419001345 |
| Provider Name | Wade T Hunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356339592 PECOS PAC ID: 3870498116 Enrollment ID: I20040419001397 |
| Provider Name | Thomas John |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770577884 PECOS PAC ID: 4789589037 Enrollment ID: I20040419001634 |
| Provider Name | Steven H Lagrant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477540789 PECOS PAC ID: 5092708743 Enrollment ID: I20040421000138 |
| Provider Name | Thang Q Le |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679567887 PECOS PAC ID: 7012812365 Enrollment ID: I20040421000284 |
| Provider Name | Ralph W Lott |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174511315 PECOS PAC ID: 2163418658 Enrollment ID: I20040421000826 |
| Provider Name | Aamer Mirza |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1730173857 PECOS PAC ID: 7517862865 Enrollment ID: I20040423000963 |
| Provider Name | Tatyana Antonevich |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528054368 PECOS PAC ID: 5597752212 Enrollment ID: I20040426001797 |
| Provider Name | Sultana Razia |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1669466884 PECOS PAC ID: 5496650756 Enrollment ID: I20040427001236 |
| Provider Name | Anthony R Sbiroli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518955756 PECOS PAC ID: 2062409444 Enrollment ID: I20040428000201 |
| Provider Name | Jerry B Sloan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578554051 PECOS PAC ID: 8022913383 Enrollment ID: I20040428000432 |
| Provider Name | Dana M Zacharewicz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417941634 PECOS PAC ID: 4688579956 Enrollment ID: I20040428000994 |
| Provider Name | Parvez Asmat |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679521777 PECOS PAC ID: 7719978550 Enrollment ID: I20040520001523 |
| Provider Name | John M Ellis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962464818 PECOS PAC ID: 7719978121 Enrollment ID: I20040524000048 |
| Provider Name | Robert A Meier |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730137738 PECOS PAC ID: 5597756965 Enrollment ID: I20040524000527 |
| Provider Name | John J Picano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912955915 PECOS PAC ID: 4082605829 Enrollment ID: I20040527000077 |
| Provider Name | John R Restivo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710935713 PECOS PAC ID: 9537140306 Enrollment ID: I20040527000212 |
| Provider Name | Nancy Ann Shaheen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194781658 PECOS PAC ID: 1951382779 Enrollment ID: I20040527000593 |
| Provider Name | John P Sullivan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942294095 PECOS PAC ID: 2062485543 Enrollment ID: I20040813000317 |
| Provider Name | Shelly L Hearn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134113343 PECOS PAC ID: 8729052071 Enrollment ID: I20040823000765 |
| Provider Name | Najmus Saqib |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134110281 PECOS PAC ID: 4284600859 Enrollment ID: I20040903001104 |
| Provider Name | George K Tomy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265426480 PECOS PAC ID: 5395794705 Enrollment ID: I20050112000890 |
| Provider Name | Jill A Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578587515 PECOS PAC ID: 7911958558 Enrollment ID: I20050201000731 |
| Provider Name | Emerita A Pizarro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679567895 PECOS PAC ID: 6709831290 Enrollment ID: I20050317000459 |
| Provider Name | Karen Rounds Cleary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922104546 PECOS PAC ID: 5294775185 Enrollment ID: I20050510000958 |
| Provider Name | Shannon M Sullivan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194716605 PECOS PAC ID: 6002840808 Enrollment ID: I20050921000623 |
| Provider Name | Thomas W Gallagher |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811985880 PECOS PAC ID: 7214961010 Enrollment ID: I20050921000687 |
| Provider Name | Linda Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538140454 PECOS PAC ID: 0840211199 Enrollment ID: I20051214000375 |
| Provider Name | Daniel William Grace |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376508846 PECOS PAC ID: 3577540566 Enrollment ID: I20060407000512 |
| Provider Name | Kwaku A Amankwah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982653457 PECOS PAC ID: 7618980814 Enrollment ID: I20060713000098 |
| Provider Name | Timothy H Lafont |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497745228 PECOS PAC ID: 8921008459 Enrollment ID: I20070108000357 |
| Provider Name | Anthony R Mangano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447216924 PECOS PAC ID: 4082711213 Enrollment ID: I20070522000465 |
| Provider Name | Nathaniel S Gould |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1164469755 PECOS PAC ID: 8325131501 Enrollment ID: I20070904000443 |
| Provider Name | Niranjan Marino Selvarajah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548256399 PECOS PAC ID: 7113987355 Enrollment ID: I20071218000172 |
| Provider Name | Steven A Rudd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932248184 PECOS PAC ID: 2668403049 Enrollment ID: I20080616000010 |
| Provider Name | Lev Goldiner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710146733 PECOS PAC ID: 6901978550 Enrollment ID: I20080626000555 |
| Provider Name | Michael J Mcnulty |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1013177450 PECOS PAC ID: 3072662576 Enrollment ID: I20090512000344 |
| Provider Name | Helen Dolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104098631 PECOS PAC ID: 9638229313 Enrollment ID: I20090618000540 |
| Provider Name | Dayal D Raja |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1003937715 PECOS PAC ID: 3072666064 Enrollment ID: I20090810000263 |
| Provider Name | Manzurul A Sikder |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1598885741 PECOS PAC ID: 9335271352 Enrollment ID: I20100709000386 |
| Provider Name | Taryn Rio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245473800 PECOS PAC ID: 7113041302 Enrollment ID: I20100824001291 |
| Provider Name | Mauricio Valencia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962453647 PECOS PAC ID: 7012102445 Enrollment ID: I20101111000621 |
| Provider Name | Raphael J Alcuri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184616039 PECOS PAC ID: 6608850243 Enrollment ID: I20110204000553 |
| Provider Name | Syed Saeed Zaman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1295729143 PECOS PAC ID: 0547441610 Enrollment ID: I20110222000992 |
| Provider Name | Matthew A Mittiga |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164686192 PECOS PAC ID: 6608052378 Enrollment ID: I20110513000063 |
| Provider Name | Haider A Khadim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174788541 PECOS PAC ID: 2163692351 Enrollment ID: I20110825000439 |
| Provider Name | Adnan Cemer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053577734 PECOS PAC ID: 5193998516 Enrollment ID: I20111101000073 |
| Provider Name | Mohsin Maqsood Syed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437291689 PECOS PAC ID: 8628136934 Enrollment ID: I20120402000137 |
| Provider Name | Brian T Burke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386770527 PECOS PAC ID: 2860660032 Enrollment ID: I20120618000425 |
| Provider Name | Annie M Wafer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699027995 PECOS PAC ID: 9638321672 Enrollment ID: I20121220000199 |
| Provider Name | Jeffrey T Kwasniewski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972938900 PECOS PAC ID: 1557591526 Enrollment ID: I20140313001487 |
| Provider Name | Aileen G Callan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982043386 PECOS PAC ID: 2567693633 Enrollment ID: I20140403000133 |
| Provider Name | David Nicholas Campola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043217730 PECOS PAC ID: 9638116817 Enrollment ID: I20140523000792 |
| Provider Name | Rohin Mehta |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1306067517 PECOS PAC ID: 8123277118 Enrollment ID: I20140625000333 |
| Provider Name | William S Gaetano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447543673 PECOS PAC ID: 9739323940 Enrollment ID: I20140826000983 |
| Provider Name | Scott M Peplinski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861456444 PECOS PAC ID: 4486634896 Enrollment ID: I20150114001928 |
| Provider Name | Prasanna V Kumar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1437280971 PECOS PAC ID: 7416967120 Enrollment ID: I20150123001057 |
| Provider Name | Apurva B Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174881387 PECOS PAC ID: 0244545135 Enrollment ID: I20150821012889 |
| Provider Name | Aida Durmisevic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295115129 PECOS PAC ID: 3375850589 Enrollment ID: I20150921003246 |
| Provider Name | Theresa Hutchings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407237753 PECOS PAC ID: 2961702600 Enrollment ID: I20151201002965 |
| Provider Name | Julia A Bramley |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1669841375 PECOS PAC ID: 4688975857 Enrollment ID: I20151211000888 |
| Provider Name | Christopher P Powers |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1497098792 PECOS PAC ID: 4082905252 Enrollment ID: I20160617000875 |
| Provider Name | Ramesh B Cherukuri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952668543 PECOS PAC ID: 8325339310 Enrollment ID: I20160622001575 |
| Provider Name | Kenneth J Visalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093081358 PECOS PAC ID: 2264724798 Enrollment ID: I20160701001274 |
| Provider Name | Susan Spring Keeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134583784 PECOS PAC ID: 4284895780 Enrollment ID: I20160811001939 |
| Provider Name | Felix Oduwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265527493 PECOS PAC ID: 4082840319 Enrollment ID: I20160909000278 |
| Provider Name | Marian E Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063863470 PECOS PAC ID: 6901194497 Enrollment ID: I20161017001619 |
| Provider Name | Tuyen Ngo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710416748 PECOS PAC ID: 2264704543 Enrollment ID: I20170822000265 |
| Provider Name | Alexander Robert Harris |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1437562451 PECOS PAC ID: 1658598537 Enrollment ID: I20180622002071 |
| Provider Name | Marwan Mohammad Al-haddad |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1518301712 PECOS PAC ID: 4587925110 Enrollment ID: I20181107000522 |
| Provider Name | Mohammad-ali Yazdani Abyaneh |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1508252784 PECOS PAC ID: 5193061273 Enrollment ID: I20190801001045 |
| Provider Name | Ethan Kent Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851952675 PECOS PAC ID: 8527397850 Enrollment ID: I20190911000977 |
| Provider Name | Erin Margaret Krupski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306407127 PECOS PAC ID: 0941539274 Enrollment ID: I20190911001129 |
| Provider Name | Stephan Barrientos |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1942437397 PECOS PAC ID: 2264730712 Enrollment ID: I20200715000608 |
| Provider Name | Maree Carmella Joy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184243156 PECOS PAC ID: 7618393471 Enrollment ID: I20200811003938 |
| Provider Name | Shannon Randa Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083232938 PECOS PAC ID: 7315364833 Enrollment ID: I20200828002614 |
| Provider Name | Shawna Rochelle Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548887607 PECOS PAC ID: 3072930312 Enrollment ID: I20200901000753 |
| Provider Name | Roxane Handal-orefice |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124461066 PECOS PAC ID: 1254563364 Enrollment ID: I20201130001824 |
| Provider Name | Keri Ann Silvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891394896 PECOS PAC ID: 7315358975 Enrollment ID: I20201203000468 |
| Provider Name | Carly Zegarelli |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093316879 PECOS PAC ID: 1759792237 Enrollment ID: I20201205000107 |
| Provider Name | Kimberly Hurley |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1255503686 PECOS PAC ID: 3476607235 Enrollment ID: I20210412002172 |
| Provider Name | Nils-tomas Mcbride |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477992378 PECOS PAC ID: 3971801259 Enrollment ID: I20210604000802 |
| Provider Name | Kristina Stoyanov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750870317 PECOS PAC ID: 1355694308 Enrollment ID: I20210614003066 |
| Provider Name | Ashley Kernstock |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699009894 PECOS PAC ID: 7416096334 Enrollment ID: I20210817003850 |
| Provider Name | Renee L Carney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194492538 PECOS PAC ID: 1355747676 Enrollment ID: I20210910001518 |
| Provider Name | Anna Mae Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841577509 PECOS PAC ID: 5991194334 Enrollment ID: I20211105000947 |
| Provider Name | Morgan Murawski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477226835 PECOS PAC ID: 3577952514 Enrollment ID: I20211115000272 |
| Provider Name | Nancy Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245996628 PECOS PAC ID: 8527451913 Enrollment ID: I20220208000104 |
| Provider Name | Kassandra E Giglio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629738422 PECOS PAC ID: 9436544202 Enrollment ID: I20220314000265 |
| Provider Name | Sara Degaetano |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194266551 PECOS PAC ID: 4880071653 Enrollment ID: I20220517000761 |
| Provider Name | Leanna Baird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699402313 PECOS PAC ID: 3072981166 Enrollment ID: I20221121002663 |
| Provider Name | Amela Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003543711 PECOS PAC ID: 8022487115 Enrollment ID: I20221212002965 |
| Provider Name | Karen Allard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588379333 PECOS PAC ID: 4486027414 Enrollment ID: I20230222001490 |
| Provider Name | Caitlin Powers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740909704 PECOS PAC ID: 0648643197 Enrollment ID: I20230302002231 |
| Provider Name | Melissa Marie Kobito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912690793 PECOS PAC ID: 7810356144 Enrollment ID: I20230705003160 |
| Provider Name | Julie Kristine Kulawy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730867565 PECOS PAC ID: 7113381559 Enrollment ID: I20230918003894 |
| Provider Name | Olivia Grace Tierno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316625106 PECOS PAC ID: 4587028931 Enrollment ID: I20230919000074 |
| Provider Name | Andrea Lynn Moehringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063106441 PECOS PAC ID: 1254786007 Enrollment ID: I20231013001116 |
| Provider Name | Ashley Rachel Parmentier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609657287 PECOS PAC ID: 3476904301 Enrollment ID: I20240104003682 |
| Provider Name | Michelle J Palumbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497534705 PECOS PAC ID: 7416308564 Enrollment ID: I20240112002536 |
Amidon Medical Group Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Ellinwood Dr, New Hartford, NY 13413 Phone: 315-507-5081 Fax: 315-738-1663 | |
Cap Medical Group Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Ellinwood Dr, New Hartford, NY 13413 Phone: 315-507-5081 Fax: 315-738-1663 | |
Samuel K Gooldy, Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Oxford Rd, Suite 304, New Hartford, NY 13413 Phone: 315-724-6611 Fax: 315-724-6366 | |
Adirondack Internal Medicine And Pediatrics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Oxford Rd, New Hartford, NY 13413 Phone: 315-724-9874 Fax: 315-724-9877 | |
Amy V Gorczynski Rn Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Ellinwood Ct, New Hartford, NY 13413 Phone: 315-507-4312 | |
Cap Medical, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 French Rd, New Hartford, NY 13413 Phone: 315-225-3534 |