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111 Elm St Ste 201 Worcester MA 01609-1967 | |
| (508) 556-1072 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 111 Elm St Ste 201, Worcester, Massachusetts |
| Authorized Official Name and Position | Lynn Gervais (PRACTICE MANAGER) |
| Authorized Official Contact | 5085561072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
111 Elm St Ste 201 Worcester MA 01609-1967 Ph: (508) 556-1072 | 111 Elm St Ste 201 Worcester MA 01609-1967 Ph: (508) 556-1072 |
| NPI Number | 1164993291 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 11/19/2024 |
| Medicare PECOS PAC ID | 3375884703 |
|---|---|
| Medicare Enrollment ID | O20190411000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164993291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Chidimma I Okoli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972823870 PECOS PAC ID: 0345486288 Enrollment ID: I20130418000393 |
| Provider Name | Julie M Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326573387 PECOS PAC ID: 3971875857 Enrollment ID: I20170828002679 |
| Provider Name | Margaret Alice Traynham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326693086 PECOS PAC ID: 1052729043 Enrollment ID: I20210412001182 |
Jain Medical Group Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Winthrop St, Worcester, MA 01604 Phone: 508-799-4100 Fax: 508-799-2388 | |
Neh Healthcare Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 475 Pleasant St, Worcester, MA 01609 Phone: 508-735-3280 | |
Worcester Internal Medicine, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 416 Belmont St, Worcester, MA 01604 Phone: 508-756-1808 Fax: 508-798-0538 | |
Anthony Distefano, Jr Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 562 Lincoln St, Worcester, MA 01605 Phone: 508-852-6028 Fax: 508-721-7821 | |
Joseph J. Savitt, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Lincoln St, Worcester, MA 01605 Phone: 508-755-1222 Fax: 508-754-9479 | |
Demos Agiomavritis Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 385 Grove St, Suite 120, Worcester, MA 01605 Phone: 508-770-8002 Fax: 508-770-8006 | |
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