Glen Sickorez (NPI# 1861445736, PAC ID# 2769429653) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1861445736 |
| PAC ID by PECOS | 2769429653 |
| Professional Enrollment ID | I20050412001171 |
| Full Name | Glen Sickorez |
| Organization Legal Name | SOUTH SHORE HEALTH EXPRESS, INC |
| Address |
119 Parkingway Quincy MA 02169-5044 |
| Phone Number | 7816265900 |
| Gender | M |
| Credential | MD |
| Medical School | UMDNJ-NEW JERSEY MEDICAL SCHOOL |
| Graduation Year | 1985 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 6406108836 |
| Number of Group Practice Members | 29 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 220177 | NANTUCKET COTTAGE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 119 Parkingway, Quincy, MA 02169-5044 | 7816265900 | SOUTH SHORE HEALTH EXPRESS, INC |
| 330 Washington St, Weymouth, MA 02188-2932 | 7816265160 | SOUTH SHORE HEALTH EXPRESS, INC |
| Organization Legal Name | SOUTH SHORE HEALTH EXPRESS, INC |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Barry F Canavan | Physician Assistant | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| David Franklin Bond | Physician Assistant | South Shore Health Express, Inc | 170 Bedford St, Abington, MA 02351-2068 |
| Antoinette E Eng | Emergency Medicine | South Shore Health Express, Inc | 330 Washington St, Weymouth, MA 02188-2932 |
| Patricia E Sullivan | Emergency Medicine | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Francis P Duggan | Emergency Medicine | South Shore Health Express, Inc | 170 Bedford St, Abington, MA 02351-2068 |
| Phyllis M Tedeschi | Nurse Practitioner | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Emil R Reinhalter | Emergency Medicine | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Ryan C Gallo | Physician Assistant | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Therese M Redmond | Nurse Practitioner | South Shore Health Express, Inc | 330 Washington St, Weymouth, MA 02188-2932 |
| Dustin L Cotliar | Emergency Medicine | South Shore Health Express, Inc | 330 Washington St, Weymouth, MA 02188-2932 |
| Street Address |
119 PARKINGWAY |
| City | QUINCY |
| State | MA |
| Zip | 02169-5044 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Barry F Canavan | Physician Assistant | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Patricia E Sullivan | Emergency Medicine | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Phyllis M Tedeschi | Nurse Practitioner | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Emil R Reinhalter | Emergency Medicine | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Ryan C Gallo | Physician Assistant | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Donald J Hansen | Emergency Medicine | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Christopher J Cannizzaro | Physician Assistant | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Joyce R Twomey | Nurse Practitioner | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Janet M Coarr | Nurse Practitioner | South Shore Health Express, Inc | 119 Parkingway, Quincy, MA 02169-5044 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy Hannon Baron | Certified Nurse Midwife | South Shore Ob-gyn Hanover Ob-gyn Inc. | 21 Mayor Mcgrath Hwy, Quincy, MA 02169 |
| Camden Marcotte | Physical Therapy | Peak Physical Therapy Inc | 2300 Crown Colony Dr, Suite 102, Quincy, MA 02169-0902 |
| Cynthia Wisted | Physical Therapy | Peak Physical Therapy Inc | 2300 Crown Colony Dr, Suite 102, Quincy, MA 02169-0902 |
| Kaylee Lecavalier | Physical Therapy | Peak Physical Therapy Inc | 2300 Crown Colony Dr, Suite 102, Quincy, MA 02169-0902 |
| Samuel Kushner | Physical Therapy | Peak Physical Therapy Inc | 2300 Crown Colony Dr, Suite 102, Quincy, MA 02169-0902 |
| Donna Chiao | Physical Therapy | Peak Physical Therapy Inc | 2300 Crown Colony Dr, Suite 102, Quincy, MA 02169-0902 |
| Kellie Fokin | Physical Therapy | Peak Physical Therapy Inc | 2300 Crown Colony Dr, Suite 102, Quincy, MA 02169-0902 |
| Matthew Haley | Physical Therapy | Peak Physical Therapy Inc | 2300 Crown Colony Dr, Suite 102, Quincy, MA 02169-0902 |
| Zachary Wagner | Physical Therapy | Peak Physical Therapy Inc | 2300 Crown Colony Dr, Suite 102, Quincy, MA 02169-0902 |
| Gary C Kimball | Physical Therapy | South Shore Sports and Muscular | 300 Congress St, Quincy, MA 02169-0907 |
| Find all physicians in zip 02169 | |||
| City | QUINCY |
| Zip Code | 02169 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | QUINCY + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Glen Sickorez.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.