Triangle Geriatric And Memory Clinic, Pllc | |
907 Kildaire Farm Rd Cary NC 27511-3922 | |
(919) 319-6610 | |
(919) 319-6365 |
Full Name | Triangle Geriatric And Memory Clinic, Pllc |
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Speciality | Internal Medicine |
Location | 907 Kildaire Farm Rd, Cary, North Carolina |
Authorized Official Name and Position | John Smith (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 9193426842 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Triangle Geriatric And Memory Clinic, Pllc 203 Michelangelo Way Cary NC 27518-8716 Ph: (919) 319-6610 | Triangle Geriatric And Memory Clinic, Pllc 907 Kildaire Farm Rd Cary NC 27511-3922 Ph: (919) 319-6610 |
NPI Number | 1427487099 |
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Provider Enumeration Date | 11/05/2013 |
Last Update Date | 08/14/2023 |
Medicare PECOS PAC ID | 8325271299 |
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Medicare Enrollment ID | O20140429001965 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427487099 | NPI | - | NPPES |
5919360 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
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207RG0300X | Internal Medicine - Geriatric Medicine | 2010-00095 (North Carolina) | Primary |
Provider Name | Ramesh B Konduru |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1477717445 PECOS PAC ID: 6608059241 Enrollment ID: I20111213000005 |
Provider Name | Janet K Ongechi |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255977526 PECOS PAC ID: 2567899628 Enrollment ID: I20200302001156 |
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