Laverne R Vandewall (NPI# 1518960590, PAC ID# 5799835948) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1518960590 |
| PAC ID by PECOS | 5799835948 |
| Professional Enrollment ID | I20100115000426 |
| Full Name | Laverne R Vandewall |
| Organization Legal Name | WATERTOWN INTERNISTS PC |
| Address |
53 -59 Public Sq Suite 301 Watertown NY 13601-2674 |
| Phone Number | 3157822141 |
| Gender | M |
| Medical School | PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1985 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 1355491606 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330157 | SAMARITAN MEDICAL CENTER |
| 331309 | RIVER HOSPITAL, INC |
| Address | Phone | Organization |
|---|---|---|
| 1575 Washington St, Watertown, NY 13601-0000 | SAMARITAN MEDICAL CENTER | |
| 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 | 3157822141 | WATERTOWN INTERNISTS PC |
| 830 Washington St, Watertown, NY 13601-4034 | 3157854000 | APOGEE MEDICAL GROUP, NEW YORK, PC |
| 830 Washington St, Watertown, NY 13601-0000 | 3157854000 | SAMARITAN MEDICAL CENTER |
| 830 Washington St, Watertown, NY 13601-4034 | SAMARITAN MEDICAL CENTER |
| Organization Legal Name | WATERTOWN INTERNISTS PC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura E Boggs | Internal Medicine | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Collins Kellogg | Internal Medicine | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Julie M Lapointe | Internal Medicine | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Jillian Young Marra | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Ann M Lepine | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Nancy J Spicer | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Kathryn A Kolton | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Jason F White | Family Medicine | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Jeff D Perrine | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Street Address |
53 -59 PUBLIC SQ SUITE 301 |
| City | WATERTOWN |
| State | NY |
| Zip | 13601-2674 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura E Boggs | Internal Medicine | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Collins Kellogg | Internal Medicine | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Julie M Lapointe | Internal Medicine | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Sarah Sugden | Qualified Audiologist | Watertown Audiology PC | 53 -59 Public Sq, Suite 202, Watertown, NY 13601-2674 |
| Jillian Young Marra | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Ann M Lepine | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Matthew Weinstein | Ophthalmology | David A Ewing-chow Md Pllc | 53 -59 Public Sq, Suite 102, Watertown, NY 13601-2674 |
| Nancy J Spicer | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| David A Ewing Chow | Ophthalmology | David A Ewing-chow Md Pllc | 53 -59 Public Sq, Suite 102, Watertown, NY 13601-2674 |
| Kathryn A Kolton | Nurse Practitioner | Watertown Internists PC | 53 -59 Public Sq, Suite 301, Watertown, NY 13601-2674 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brett R Bunker | Physician Assistant | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Maria N Alicea | Physician Assistant | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Christina M Oneil | Clinical Social Worker | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Christopher Wilson | Nurse Practitioner | Samaritan Medical Center | 830 Washington St, Pm and R, Watertown, NY 13601-0000 |
| Catherine Vreatt | Clinical Social Worker | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Zachary Nahmias | Dermatology | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Makenzie Rae Griffin | Nurse Practitioner | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Bonnie L Servage | Nurse Practitioner | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Erica Feola | Physician Assistant | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Maryellen I Blevins | Physician Assistant | Samaritan Medical Center | 1575 Washington St, Watertown, NY 13601-0000 |
| Find all physicians in zip 13601 | |||
| City | WATERTOWN |
| Zip Code | 13601 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | WATERTOWN + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Laverne R Vandewall.
| 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.