Atul Odhavji Dalsania (NPI# 1225086895, PAC ID# 3274569264) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1225086895 |
| PAC ID by PECOS | 3274569264 |
| Professional Enrollment ID | I20050712000045 |
| Full Name | Atul Odhavji Dalsania |
| Organization Legal Name | CLEAN SLATE MEDICAL GROUP OF PENNSYLVANIA LLC |
| Address |
1020 W Lackawanna Ave Scranton PA 18504-2052 |
| Phone Number | 4135842173 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1989 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 8426334400 |
| Number of Group Practice Members | 27 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390001 | GEISINGER-COMMUNITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1020 W Lackawanna Ave, Scranton, PA 18504-2052 | 4135842173 | CLEAN SLATE MEDICAL GROUP OF PENNSYLVANIA LLC |
| Organization Legal Name | CLEAN SLATE MEDICAL GROUP OF PENNSYLVANIA LLC |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark Bohn | Family Medicine | Clean Slate Medical Group of Pennsylvania LLC | 189 E Market St, Wilkes Barre, PA 18702-5243 |
| Lori J Wain | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 329 Pine St, Williamsport, PA 17701-6216 |
| Mindi Nichols | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Roxanne M Sides | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 3380 Memphis St, Philadelphia, PA 19134-4510 |
| Cydnee Allene Sankey-deemer | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 501 Howard Ave, Suite A202, Altoona, PA 16601-4810 |
| Ellen B Linde | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Faizmohamed Mansuri | Internal Medicine | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Jay Willner | Obstetrics/gynecology | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Amber L Petty | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 329 Pine St, Williamsport, PA 17701-6216 |
| Caitlyn Rivero | Physician Assistant | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Street Address |
1020 W LACKAWANNA AVE |
| City | SCRANTON |
| State | PA |
| Zip | 18504-2052 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mindi Nichols | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Ellen B Linde | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Faizmohamed Mansuri | Internal Medicine | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Jay Willner | Obstetrics/gynecology | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Caitlyn Rivero | Physician Assistant | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Marlaina Burns | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Julie Ann Ohara | Internal Medicine | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Todd W Fausnaught | Family Medicine | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Ann Narcoonis | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Carissa Welles | Physician Assistant | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Serena Marie Ross | Qualified Audiologist | 444 N Main Ave, Scranton, PA 18504-1720 | |
| Eric D Smith | Internal Medicine | 409 N Main Ave, Suite 1, Scranton, PA 18504-1798 | |
| Michael Klingerman | Internal Medicine | 1209 Swetland St, Swetland Office, Scranton, PA 18504-1849 | |
| Gerard Nealon | Internal Medicine | 1209 Swetland St, Scranton, PA 18504-1849 | |
| Robert Walter Kaville | Internal Medicine | 399 N 9th Ave, Scranton, PA 18504-2005 | |
| William S Auriemma | Colorectal Surgery (proctology) | 381 N 9th Ave, Scranton, PA 18504-2005 | |
| Christine M Kmiec | Chiropractic | 371 N 9th Ave, Scranton, PA 18504-2005 | |
| Michael J Turock | Family Medicine | 397 N 9th Ave, Scranton, PA 18504-2005 | |
| Hema Annappa Metgud | Internal Medicine | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Emily Jean Way | Nurse Practitioner | Clean Slate Medical Group of Pennsylvania LLC | 1020 W Lackawanna Ave, Scranton, PA 18504-2052 |
| Find all physicians in zip 18504 | |||
| City | SCRANTON |
| Zip Code | 18504 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | SCRANTON + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Atul Odhavji Dalsania.
| 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.