Jacqueline J Gagen (NPI# 1811964281, PAC ID# 4587979737) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1811964281 |
| PAC ID by PECOS | 4587979737 |
| Professional Enrollment ID | I20180829002999 |
| Full Name | Jacqueline J Gagen |
| Organization Legal Name | REGIONAL MEDICAL PRACTICE, PC |
| Address |
82 Copeland Ave Homer NY 13077-1528 |
| Phone Number | 6077531025 |
| Gender | F |
| Graduation Year | 2009 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9032115233 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330175 | CORTLAND REGIONAL MEDICAL CENTER, INC |
| Address | Phone | Organization |
|---|---|---|
| 82 Copeland Ave, Homer, NY 13077-1528 | 6077531025 | REGIONAL MEDICAL PRACTICE, PC |
| Organization Legal Name | REGIONAL MEDICAL PRACTICE, PC |
| Physicians | 48 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mohammad Fahad Ali | Gastroenterology | Regional Medical Practice, PC | 11 Alvena Ave, Suite 105, Cortland, NY 13045-1100 |
| Shamanthy Ratnasingam | Internal Medicine | Regional Medical Practice, PC | 82 Copeland Ave, Homer, NY 13077-1528 |
| Charley B Gates | Orthopedic Surgery | Regional Medical Practice, PC | 1104 Commons Ave, Cortland, NY 13045-1643 |
| Ngozi C Mezu | Infectious Disease | Regional Medical Practice, PC | 134 Homer Ave, Cortland, NY 13045-1206 |
| James Samuel Leonard | Podiatry | Regional Medical Practice, PC | 1095 Commons Ave, Cortland, NY 13045-1669 |
| Jenniferleigh V Clune | Nurse Practitioner | Regional Medical Practice, PC | 4077 W Rd, Cortland, NY 13045-1637 |
| Christopher H Moheimani | General Surgery | Regional Medical Practice, PC | 1259 Fisher Ave, Cortland, NY 13045-1012 |
| Bruce C Slagle | Family Medicine | Regional Medical Practice, PC | 134 Homer Ave, Cortland, NY 13045-1206 |
| Susan E Jewett | Physician Assistant | Regional Medical Practice, PC | 134 Homer Ave, Cortland, NY 13045-1206 |
| Mahmoud Chehab | Urology | Regional Medical Practice, PC | 134 Homer Ave, Cortland, NY 13045-1206 |
| Street Address |
82 COPELAND AVE |
| City | HOMER |
| State | NY |
| Zip | 13077-1528 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shamanthy Ratnasingam | Internal Medicine | Regional Medical Practice, PC | 82 Copeland Ave, Homer, NY 13077-1528 |
| Andras Szabo | Internal Medicine | Regional Medical Practice, PC | 82 Copeland Ave, Homer, NY 13077-1528 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert P Morris | Dermatology | 46 N Fulton St, Homer, NY 13077-1029 | |
| Ehren P Heyer | Physical Therapy | 27 N Main St, Homer, NY 13077-1314 | |
| Lisa Marie Loomis | Clinical Social Worker | 2 Wall St, Homer, NY 13077-1321 | |
| Nicole L Villapiano | Internal Medicine | Family Health Network of Central New York Inc | 85 S W St, Homer, NY 13077-1500 |
| Robert B Slater | Clinical Social Worker | 24 Copeland Ave, Homer, NY 13077-1529 | |
| Janet D Rider | Clinical Social Worker | Copeland Ave Counseling Lcsw Pllc | 24 Copeland Ave, Homer, NY 13077-1529 |
| Joanne G Brumm | Clinical Social Worker | Copeland Ave Counseling Lcsw Pllc | 24 Copeland Ave, Homer, NY 13077-1529 |
| Donna J Lucente | Clinical Social Worker | Copeland Ave Counseling Lcsw Pllc | 24 Copeland Ave, Homer, NY 13077-1529 |
| City | HOMER |
| Zip Code | 13077 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | HOMER + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jacqueline J Gagen.
| 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.