| Urban Health Plan, Inc. | |
|
1065 Southern Blvd Bronx NY 10459-2417 | |
| (718) 589-2440 | |
| (718) 991-4516 |
| Full Name | Urban Health Plan, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1065 Southern Blvd, Bronx, New York |
| Authorized Official Name and Position | Samuel Deleon (MD, VP/CMO) |
| Authorized Official Contact | 7185892440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Urban Health Plan, Inc. 1065 Southern Blvd Bronx NY 10459-2417 Ph: (718) 589-2440 | Urban Health Plan, Inc. 1065 Southern Blvd Bronx NY 10459-2417 Ph: (718) 589-2440 |
| NPI Number | 1265596548 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 03/17/2011 |
| Medicare PECOS PAC ID | 3173517281 |
|---|---|
| Medicare Enrollment ID | O20040412001518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265596548 | NPI | - | NPPES |
| 00244977 | Medicaid | NY | |
| 02994952 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Jacinto T Casas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609884097 PECOS PAC ID: 0941114714 Enrollment ID: I20031117000142 |
| Provider Name | Boris G Chusid |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518967769 PECOS PAC ID: 3577453554 Enrollment ID: I20040316000520 |
| Provider Name | Charles L Cooper |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205836590 PECOS PAC ID: 5294625547 Enrollment ID: I20040318001441 |
| Provider Name | Patricia Althea Anderson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710983044 PECOS PAC ID: 9133011554 Enrollment ID: I20040329001067 |
| Provider Name | Acklema Mohammad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932106291 PECOS PAC ID: 3375435704 Enrollment ID: I20040329001096 |
| Provider Name | Diosmary A Oliva |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1720194038 PECOS PAC ID: 9638061989 Enrollment ID: I20040330000119 |
| Provider Name | Olga Evdos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831123066 PECOS PAC ID: 3375535958 Enrollment ID: I20040401001686 |
| Provider Name | Joseph D'amore |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1932193513 PECOS PAC ID: 9436145463 Enrollment ID: I20040507001358 |
| Provider Name | Franklin Velazquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952479305 PECOS PAC ID: 4082603477 Enrollment ID: I20040511000273 |
| Provider Name | Kenneth Hernandez |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215900428 PECOS PAC ID: 3173512589 Enrollment ID: I20040511000469 |
| Provider Name | Michael John Napoli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699782490 PECOS PAC ID: 2365432945 Enrollment ID: I20040514001266 |
| Provider Name | Mussarat A Chaudhry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487645438 PECOS PAC ID: 8123019528 Enrollment ID: I20040524000743 |
| Provider Name | Jacalyn Bitterman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164432902 PECOS PAC ID: 1658355664 Enrollment ID: I20040616001440 |
| Provider Name | Julio Ricardo Quintanilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932214467 PECOS PAC ID: 3779567797 Enrollment ID: I20040616001501 |
| Provider Name | Sara Palomino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972618460 PECOS PAC ID: 5294719217 Enrollment ID: I20040616001527 |
| Provider Name | Claude Parola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609872035 PECOS PAC ID: 9537143557 Enrollment ID: I20040616001558 |
| Provider Name | Wilfrido Arturo Castillo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366456931 PECOS PAC ID: 8426032244 Enrollment ID: I20040617000708 |
| Provider Name | Samuel A Deleon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770589111 PECOS PAC ID: 4183608839 Enrollment ID: I20040617001694 |
| Provider Name | Shamiza Alima Ally |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154337244 PECOS PAC ID: 2769467273 Enrollment ID: I20040621000182 |
| Provider Name | Gregory J Rios |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538275094 PECOS PAC ID: 6800871989 Enrollment ID: I20040622001444 |
| Provider Name | Adel Ramsey Abadir |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1760407068 PECOS PAC ID: 4880670546 Enrollment ID: I20040624001697 |
| Provider Name | Michele Marie Greco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871561076 PECOS PAC ID: 3173503489 Enrollment ID: I20040726000434 |
| Provider Name | Myo Maw |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871565242 PECOS PAC ID: 4789657081 Enrollment ID: I20040816000583 |
| Provider Name | Stewart I Schwartz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598853921 PECOS PAC ID: 2264494632 Enrollment ID: I20041028000267 |
| Provider Name | Kenneth John Herwig |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205932415 PECOS PAC ID: 6406814771 Enrollment ID: I20050103000878 |
| Provider Name | Apryl M Mcneil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699929810 PECOS PAC ID: 2769430404 Enrollment ID: I20050110000188 |
| Provider Name | Rachana N Chowlera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932153087 PECOS PAC ID: 9638105984 Enrollment ID: I20050708000887 |
| Provider Name | Tejas Parikh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750347126 PECOS PAC ID: 1355374703 Enrollment ID: I20050915000584 |
| Provider Name | Absylom K Nyamekye |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215909288 PECOS PAC ID: 9234164310 Enrollment ID: I20050927001473 |
| Provider Name | Lillian Elisa Santana-resto |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477651529 PECOS PAC ID: 8921028069 Enrollment ID: I20051203000021 |
| Provider Name | Helen Chang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376590638 PECOS PAC ID: 0941216675 Enrollment ID: I20060303000498 |
| Provider Name | Laura E Toner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609812866 PECOS PAC ID: 7517068562 Enrollment ID: I20070720000705 |
| Provider Name | Joe A Baez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669594347 PECOS PAC ID: 7113010281 Enrollment ID: I20070905000597 |
| Provider Name | Ian G Harnik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851506737 PECOS PAC ID: 3476648007 Enrollment ID: I20070927000562 |
| Provider Name | Luz E Vargas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104840610 PECOS PAC ID: 9133287980 Enrollment ID: I20081022000576 |
| Provider Name | Manuel J Vazquez Ayala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083677223 PECOS PAC ID: 7810895331 Enrollment ID: I20081103000330 |
| Provider Name | Anna Rochelle Escalona-deolall |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073629556 PECOS PAC ID: 3971663188 Enrollment ID: I20081118000557 |
| Provider Name | Michael Waldman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467434613 PECOS PAC ID: 6901953751 Enrollment ID: I20090413000396 |
| Provider Name | Wanda Ivelisse Marquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306086533 PECOS PAC ID: 1759431133 Enrollment ID: I20090604000669 |
| Provider Name | Lloyd E Bailey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689707499 PECOS PAC ID: 2466592803 Enrollment ID: I20091216000403 |
| Provider Name | Angela L King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376657403 PECOS PAC ID: 7113053570 Enrollment ID: I20100325000230 |
| Provider Name | Ana E Rojas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407951775 PECOS PAC ID: 5698828374 Enrollment ID: I20100917000259 |
| Provider Name | Karen Ernst |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851386403 PECOS PAC ID: 5799800264 Enrollment ID: I20100921000911 |
| Provider Name | Michelle Espaldon Llamera |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427353135 PECOS PAC ID: 5294919817 Enrollment ID: I20110406000328 |
| Provider Name | Viju Jacob |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134135114 PECOS PAC ID: 9436327756 Enrollment ID: I20110712000472 |
| Provider Name | Christopher Reynon Mejia |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1124035654 PECOS PAC ID: 3476721697 Enrollment ID: I20110714000065 |
| Provider Name | Jennifer Genuardi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154450146 PECOS PAC ID: 7214003805 Enrollment ID: I20110714000579 |
| Provider Name | Angel Ruiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982866521 PECOS PAC ID: 9234307315 Enrollment ID: I20110715000001 |
| Provider Name | Maggie Rourke |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1609166388 PECOS PAC ID: 9234307349 Enrollment ID: I20110715000353 |
| Provider Name | Cynthia Ann Joseph |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730338278 PECOS PAC ID: 8729256607 Enrollment ID: I20110720000186 |
| Provider Name | Sonia Sanchez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1659350080 PECOS PAC ID: 8820266265 Enrollment ID: I20110729000304 |
| Provider Name | Nicole A Reide |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1235264995 PECOS PAC ID: 6305003575 Enrollment ID: I20120131000836 |
| Provider Name | Janely Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972751337 PECOS PAC ID: 5496917148 Enrollment ID: I20120426000002 |
| Provider Name | Hernando Orjuela |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295732253 PECOS PAC ID: 3779532007 Enrollment ID: I20120807000474 |
| Provider Name | Racquel K Millwood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013291574 PECOS PAC ID: 4284871526 Enrollment ID: I20130506000352 |
| Provider Name | Monalyn Labitigan Zouzias |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1932366101 PECOS PAC ID: 5395984603 Enrollment ID: I20130618000328 |
| Provider Name | Anastasia Libovich |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1275965121 PECOS PAC ID: 4183858608 Enrollment ID: I20131015002160 |
| Provider Name | Ayelet Yoles |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992757538 PECOS PAC ID: 9931335908 Enrollment ID: I20131121000883 |
| Provider Name | Aristotle Matalang Iringan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992818983 PECOS PAC ID: 0547496275 Enrollment ID: I20131202000313 |
| Provider Name | Mary E Mastrianni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588004717 PECOS PAC ID: 7214165372 Enrollment ID: I20140117000004 |
| Provider Name | Alejandra Morales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942250238 PECOS PAC ID: 1153551536 Enrollment ID: I20140304001503 |
| Provider Name | Ama Bua Degraft-johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720312598 PECOS PAC ID: 3971733064 Enrollment ID: I20140312000456 |
| Provider Name | Jhon R Ruiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932299195 PECOS PAC ID: 0648401638 Enrollment ID: I20140314000490 |
| Provider Name | Matthew Scott Kusher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003130527 PECOS PAC ID: 3274764048 Enrollment ID: I20140319001295 |
| Provider Name | Gladys Yaneth Raveneau |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902038870 PECOS PAC ID: 5496986283 Enrollment ID: I20140319001944 |
| Provider Name | Juan Villafana |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578790440 PECOS PAC ID: 3274660576 Enrollment ID: I20140429000410 |
| Provider Name | Divya Balachandar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528225513 PECOS PAC ID: 1658594247 Enrollment ID: I20140529001401 |
| Provider Name | Maryam Mirzaagha |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1417209651 PECOS PAC ID: 7315161346 Enrollment ID: I20140613001437 |
| Provider Name | Jobin Abraham Danesh |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1386069706 PECOS PAC ID: 1557684370 Enrollment ID: I20150102000627 |
| Provider Name | Alvin A Lindsay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013152214 PECOS PAC ID: 6800114851 Enrollment ID: I20150423000884 |
| Provider Name | Nathaniel Margolis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073747259 PECOS PAC ID: 4183943889 Enrollment ID: I20150430001808 |
| Provider Name | Khadra A Said |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1366845653 PECOS PAC ID: 3577884055 Enrollment ID: I20150609002191 |
| Provider Name | Gustavo Adolfo Morales |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851524706 PECOS PAC ID: 8022329994 Enrollment ID: I20150618001343 |
| Provider Name | Ashley Baglieri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972837763 PECOS PAC ID: 9830402254 Enrollment ID: I20150714002245 |
| Provider Name | Tatiana Villa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144573908 PECOS PAC ID: 0345540571 Enrollment ID: I20151119002471 |
| Provider Name | Reubin Davoudzadeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306145057 PECOS PAC ID: 3577858745 Enrollment ID: I20160826001268 |
| Provider Name | Cynthia I Victor-prophete |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134449044 PECOS PAC ID: 7810277068 Enrollment ID: I20161206001702 |
| Provider Name | Elizabeth Etienne |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134517089 PECOS PAC ID: 9335429158 Enrollment ID: I20161213000181 |
| Provider Name | Smirna Suarez De Leon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1659555753 PECOS PAC ID: 6800177627 Enrollment ID: I20170110000002 |
| Provider Name | Pallavi Cherukuri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083905897 PECOS PAC ID: 7719263342 Enrollment ID: I20170417000676 |
| Provider Name | Monica J Montalvo |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1538614797 PECOS PAC ID: 4082986682 Enrollment ID: I20170816003501 |
| Provider Name | Fatumata E Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992967277 PECOS PAC ID: 3971875337 Enrollment ID: I20170818002091 |
| Provider Name | Johanna Rosalia Suriel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538422233 PECOS PAC ID: 2860750395 Enrollment ID: I20171211001562 |
| Provider Name | Lonzo L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114376720 PECOS PAC ID: 0941568224 Enrollment ID: I20171214000089 |
| Provider Name | Phone N Oo |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1093158248 PECOS PAC ID: 0840553319 Enrollment ID: I20180416000625 |
| Provider Name | Vanessa Rocio Solar Alvarez |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1417202615 PECOS PAC ID: 6406119874 Enrollment ID: I20180417002450 |
| Provider Name | Naeem Abbas |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437432192 PECOS PAC ID: 2365790599 Enrollment ID: I20180806000360 |
| Provider Name | Lindsey Brooke Scharfman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902149412 PECOS PAC ID: 2264783513 Enrollment ID: I20180925003231 |
| Provider Name | Ramon Arturo Blandino |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1790840494 PECOS PAC ID: 3779827332 Enrollment ID: I20181207002389 |
| Provider Name | Anyelina Maria De La Cruz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821493370 PECOS PAC ID: 4486995784 Enrollment ID: I20190415002800 |
| Provider Name | Richard Torres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871599175 PECOS PAC ID: 6204748478 Enrollment ID: I20190416000586 |
| Provider Name | Qammarah Maria Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588194781 PECOS PAC ID: 0840531034 Enrollment ID: I20190417000682 |
| Provider Name | Diana Vanessa Montoya |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1922524412 PECOS PAC ID: 5496096596 Enrollment ID: I20190417001505 |
| Provider Name | Zeena Aleeza Bacchus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255805206 PECOS PAC ID: 1153662242 Enrollment ID: I20190418001932 |
| Provider Name | Jocarie Gonell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992201107 PECOS PAC ID: 6002158813 Enrollment ID: I20190426001559 |
| Provider Name | Jamie Jianmin Meng |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437413036 PECOS PAC ID: 1254673098 Enrollment ID: I20190429000418 |
| Provider Name | Kristina Marie Caldararo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144654393 PECOS PAC ID: 8022342765 Enrollment ID: I20190628001638 |
| Provider Name | Mohammadmehdi Omidvari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194137760 PECOS PAC ID: 8921337155 Enrollment ID: I20190912001947 |
| Provider Name | Lissette Argentina Vasquez-restituyo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285091371 PECOS PAC ID: 9335575273 Enrollment ID: I20200212001627 |
| Provider Name | Ghulam Mustafa |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1932593746 PECOS PAC ID: 2466799424 Enrollment ID: I20210126002060 |
| Provider Name | Maria Delia Crosby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013513217 PECOS PAC ID: 6507271004 Enrollment ID: I20210216000454 |
| Provider Name | Quilvio Antonio Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093337834 PECOS PAC ID: 3971910985 Enrollment ID: I20210318000435 |
| Provider Name | Rima Parikh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881178267 PECOS PAC ID: 3779988977 Enrollment ID: I20210826001511 |
| Provider Name | Xian De Cheung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508358755 PECOS PAC ID: 7810316916 Enrollment ID: I20210828000058 |
| Provider Name | Emily Katherine Nash Tinucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295302164 PECOS PAC ID: 8527465038 Enrollment ID: I20210927002053 |
| Provider Name | Jaime Elizabeth Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841748373 PECOS PAC ID: 7618375759 Enrollment ID: I20211005000296 |
| Provider Name | Olga Maria Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801402524 PECOS PAC ID: 7618365875 Enrollment ID: I20211021001174 |
| Provider Name | Mariel Frances Owen-simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508533126 PECOS PAC ID: 7618365545 Enrollment ID: I20211027000122 |
| Provider Name | Kevin William Cates |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720582190 PECOS PAC ID: 7315338183 Enrollment ID: I20220105001528 |
| Provider Name | Patricia My Trang Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972127454 PECOS PAC ID: 8820400518 Enrollment ID: I20220126000121 |
| Provider Name | Samantha Ann-marie Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710410618 PECOS PAC ID: 6204220072 Enrollment ID: I20220222001639 |
| Provider Name | Melissa Enid Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194223263 PECOS PAC ID: 4284020199 Enrollment ID: I20220401000350 |
| Provider Name | Jenny Mahealani Sanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033864152 PECOS PAC ID: 8628464351 Enrollment ID: I20220406001792 |
| Provider Name | Christiane Magdi Pacheco |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508984329 PECOS PAC ID: 2466848932 Enrollment ID: I20220408002154 |
| Provider Name | Divina Castillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104200385 PECOS PAC ID: 5799172342 Enrollment ID: I20220428001703 |
| Provider Name | Chelsea Caressa Monique Burrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063083129 PECOS PAC ID: 4284015181 Enrollment ID: I20220725001320 |
| Provider Name | Jonathan Grill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578210456 PECOS PAC ID: 4284016585 Enrollment ID: I20220803001840 |
| Provider Name | Marissa Gloria Cardillo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346709193 PECOS PAC ID: 4385027762 Enrollment ID: I20220817002811 |
| Provider Name | Kelly Kristine Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629691142 PECOS PAC ID: 6507232089 Enrollment ID: I20221025002017 |
| Provider Name | Elizabeth Antoinette Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053953059 PECOS PAC ID: 4385010701 Enrollment ID: I20221026000708 |
| Provider Name | Yomaira Rosario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851946743 PECOS PAC ID: 4385011733 Enrollment ID: I20221027003074 |
| Provider Name | Martha Tatiana Lucero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518698117 PECOS PAC ID: 7911374186 Enrollment ID: I20221031002517 |
| Provider Name | Helen Melissa Gonzalez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740718295 PECOS PAC ID: 5597132621 Enrollment ID: I20221102003018 |
| Provider Name | Gloria Andrea Lamprea-duran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386201747 PECOS PAC ID: 3072980085 Enrollment ID: I20221104000167 |
| Provider Name | Sarah Ariana Albert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851886295 PECOS PAC ID: 9234506270 Enrollment ID: I20221104001058 |
| Provider Name | Alisha Ann Persad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043812951 PECOS PAC ID: 1557738473 Enrollment ID: I20221107002125 |
| Provider Name | Dennis Nunez Pelaez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568953289 PECOS PAC ID: 0749524676 Enrollment ID: I20221114001352 |
| Provider Name | Anam Tariq |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356002539 PECOS PAC ID: 1456729714 Enrollment ID: I20221118000218 |
| Provider Name | Nicole Elizabeth Lesnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710649884 PECOS PAC ID: 9537537725 Enrollment ID: I20221118001704 |
| Provider Name | Francis Burrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881137826 PECOS PAC ID: 6406224484 Enrollment ID: I20221122003617 |
| Provider Name | Amelia Ann Cover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255984993 PECOS PAC ID: 8628405669 Enrollment ID: I20230111002189 |
| Provider Name | Josephine Orlena Santiago |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558865006 PECOS PAC ID: 2466823950 Enrollment ID: I20230119002696 |
| Provider Name | Amanda Kantor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881149698 PECOS PAC ID: 3173865649 Enrollment ID: I20230626001936 |
| Provider Name | Tori Bronaugh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255446753 PECOS PAC ID: 1951343417 Enrollment ID: I20230814000146 |
| Provider Name | Ester Rose Wasserman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699462226 PECOS PAC ID: 4082063367 Enrollment ID: I20231212002157 |
| Provider Name | Noleen Camille Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760192777 PECOS PAC ID: 9739539396 Enrollment ID: I20231221002978 |
| Provider Name | Mona Sammy Elabbasy |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1437890688 PECOS PAC ID: 8426401738 Enrollment ID: I20240201003820 |
| Provider Name | Yuhong Chen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528746237 PECOS PAC ID: 7618312984 Enrollment ID: I20240226003344 |
| Provider Name | Gloria Maria Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013608595 PECOS PAC ID: 9032555180 Enrollment ID: I20240311003839 |
| Provider Name | Morgan Thomas Neyland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093107765 PECOS PAC ID: 5698111615 Enrollment ID: I20240313001811 |
| Provider Name | Yessenia Catherine Jurado |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235778291 PECOS PAC ID: 2860817467 Enrollment ID: I20240313003363 |
| Provider Name | Ashley Rene Trinidad |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215790324 PECOS PAC ID: 7911343827 Enrollment ID: I20240314001211 |
| Provider Name | Priyanka Bhardwaj |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104434497 PECOS PAC ID: 8022428978 Enrollment ID: I20240319003942 |
| Provider Name | Liliana Silebi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184402646 PECOS PAC ID: 4284071796 Enrollment ID: I20240320000593 |
| Provider Name | Alyssa Maye Jang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316708639 PECOS PAC ID: 8022455542 Enrollment ID: I20240320000887 |
| Provider Name | Angela Jeanette Cameron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598407348 PECOS PAC ID: 0749627271 Enrollment ID: I20240320001354 |
| Provider Name | Jenna Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770254880 PECOS PAC ID: 0547607442 Enrollment ID: I20240327003586 |
| Provider Name | Veraluz Adelina De Leon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497247100 PECOS PAC ID: 8123466919 Enrollment ID: I20240328003344 |
| Provider Name | Janki Girish Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508635558 PECOS PAC ID: 3577901008 Enrollment ID: I20240403002365 |
| Provider Name | Samara Brooke Kravitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265113039 PECOS PAC ID: 3375981814 Enrollment ID: I20240403002886 |
| Provider Name | Yei Won Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Dentistry |
| Provider Identifiers | NPI Number: 1770041204 PECOS PAC ID: 2860830213 Enrollment ID: I20240403003485 |
| Provider Name | Megan Elizabeth Greis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679351688 PECOS PAC ID: 9133567266 Enrollment ID: I20240409000763 |
| Provider Name | Luis Antonio Caceres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053803742 PECOS PAC ID: 3779829510 Enrollment ID: I20240426002437 |
| Provider Name | Monica Castle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548898349 PECOS PAC ID: 0749722817 Enrollment ID: I20240604002599 |
Mmc Medical Park At 1635 Poplar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Mmc Medical Park At 1635 Poplar, 1635 Poplar Street, Bronx, NY 10461 Phone: 914-377-4722 | |
Mmc At Aecom Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1300 Morris Park Avenue, Mmc At Aecom, Bronx, NY 10461 Phone: 914-377-4722 | |
Brightpoint Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1543-1545 Inwood Avenue, Bronx, NY 10452 Phone: 855-687-8700 Fax: 718-294-4765 | |
Aramark Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1650 Grand Concourse, Bronx, NY 10457 Phone: 646-641-7427 | |
Mmc At Melrose 260 E 161 Street Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 260 E 161st St, Bronx, NY 10451 Phone: 718-920-4321 | |
Amth Medical Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 369 E 149th St, 4th Floor, Bronx, NY 10455 Phone: 718-665-8300 | |
New Genesis Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3485 E Tremont Ave Fl 2, Bronx, NY 10465 Phone: 718-828-1549 Fax: 516-303-0968 |