New York State Department of Health, Wadsworth Center
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PFI: F687 Secondary Site ID: 0000 Certification Type: WAIVER Director: Mardik M Donikyan, M.D. Phone: (646) 215-6431 Fax: Address: 462 1st Ave - Bldg H Suite 7N, New York, NY 10016 County: New York Country: United States Single or Primary Contact: Gary Steidl Contact Phone: (646) 215-6482 CLIA #: 33D2276642
PFI: F688 Secondary Site ID: 0000 Certification Type: WAIVER Director: Mardik M Donikyan, M.D. Phone: (646) 215-6431 Fax: Address: 330 W 58th St - Suite 509, New York, NY 10019 County: New York Country: United States Single or Primary Contact: Gary Steidl Contact Phone: (646) 215-6482 CLIA #: 33D2276644
PFI: F691 Secondary Site ID: 0000 Certification Type: WAIVER Director: Patria R Gonzalez, M.D. Phone: (212) 795-3000 Fax: (212) 795-3263 Address: 435 Fort Washington Ave - Apt 1H, New York, NY 10033 County: New York Country: United States Single or Primary Contact: Dalia Polanco Contact Phone: (917) 224-5270 CLIA #: 33D2284108
PFI: F695 Secondary Site ID: 0000 Certification Type: WAIVER Director: Andrew N Kornstein, M.D. Phone: (203) 292-9190 Fax: (203) 698-5014 Address: 222 Westchester Ave - Suite 102, West Harrison, NY 10604 County: Westchester Country: United States Single or Primary Contact: Christine Brown Contact Phone: (914) 299-1418 CLIA #: 33D2275252
PFI: F696 Secondary Site ID: 0000 Certification Type: WAIVER Director: Jerry R. Emmons, M.D. Phone: (607) 274-4582 Fax: (607) 274-4527 Address: 101 Dates Drive, Ithaca, NY 14850 County: Schuyler Country: United States Single or Primary Contact: Scott Lyerla Contact Phone: (618) 980-8597 CLIA #: 33D2275520
PFI: F698 Secondary Site ID: 0000 Certification Type: WAIVER Director: Michael C O'Brien, M.D. Phone: (716) 879-6675 Fax: (716) 879-6644 Address: 1835 Sheridan Dr, Tonawanda, NY 14223 County: Erie Country: United States Single or Primary Contact: Matthew DeRose Contact Phone: (716) 879-6675 CLIA #: 33D2275254
PFI: F702 Secondary Site ID: 0000 Certification Type: WAIVER Director: Daniel Garber, Pharm.D. Phone: (718) 720-1111 Fax: (718) 720-1120 Address: 251 Port Richmond Ave, Staten Island, NY 10302 County: Richmond Country: United States Single or Primary Contact: Contact Phone: CLIA #: 33D2276655
PFI: F705 Secondary Site ID: 0000 Certification Type: WAIVER Director: Joseph A Bart, D.O. Phone: (716) 652-6760 Fax: Address: 1071 Jamison Road, Elma, NY 14059 County: Erie Country: United States Single or Primary Contact: Dan Wilson Contact Phone: (716) 359-5866 CLIA #: 33D2277107
PFI: F706 Secondary Site ID: 0000 Certification Type: WAIVER Director: Navjot Kaur, N.P. Phone: (929) 813-3800 Fax: (929) 813-3801 Address: 399 Park Ave - Sublevel 2, New York, NY 10022 County: New York Country: United States Single or Primary Contact: Jason Gauvin Contact Phone: (929) 813-3800 CLIA #: 33D2276651
PFI: F707 Secondary Site ID: 0000 Certification Type: PPMP Director: Sue A Stucker, N.P. Phone: (315) 668-3910 Fax: (315) 668-1940 Address: 4 Gertrude Drive, Central Square, NY 13036 County: Onondaga Country: United States Single or Primary Contact: Christine Monroe Contact Phone: (315) 668-3908 CLIA #: 33D2276652
East Side Physicans of NYC PLLC dba MiDoctor Primary Care
PFI: F708 Secondary Site ID: 0000 Certification Type: WAIVER Director: Vino K Palli, M.D. Phone: (646) 609-1012 Fax: (212) 688-1243 Address: 420 E 51st St - Office A, New York, NY 10022 County: New York Country: United States Single or Primary Contact: Shinthia Hossain Contact Phone: (631) 355-4586 CLIA #: 33D2276653