Mofoluso O Agbelese (NPI# 1194178558, PAC ID# 3779870076) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1194178558 |
| PAC ID by PECOS | 3779870076 |
| Professional Enrollment ID | I20160930000866 |
| Full Name | Mofoluso O Agbelese |
| Organization Legal Name | THE PROVIDENCE COMMUNITY HEALTH CENTERS INC. |
| Address |
239 Cranston St Providence RI 02907-2406 |
| Phone Number | 4014440580 |
| Gender | F |
| Medical School | UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9335050962 |
| Number of Group Practice Members | 70 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 410010 | WOMEN & INFANTS HOSPITAL OF RHODE ISLAND |
| Address | Phone | Organization |
|---|---|---|
| 239 Cranston St, Providence, RI 02907-2406 | 4014440580 | THE PROVIDENCE COMMUNITY HEALTH CENTERS INC. |
| Organization Legal Name | THE PROVIDENCE COMMUNITY HEALTH CENTERS INC. |
| Physicians | 64 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jenny R David | Obstetrics/gynecology | The Providence Community Health Centers Inc. | 40 Candace St, Providence, RI 02908-3747 |
| Angel M. Eads | Family Medicine | The Providence Community Health Centers Inc. | 355 Prairie Ave, Providence, RI 02905-1928 |
| Ekknoor K. Sahota | Internal Medicine | The Providence Community Health Centers Inc. | 100 Curtis St, Providence, RI 02909-3623 |
| Clarissa D. Lewis | Optometry | The Providence Community Health Centers Inc. | 335 Prairie Ave, Fl 2, Providence, RI 02905-1924 |
| Phina A Mayu | Nurse Practitioner | The Providence Community Health Centers Inc. | 1 Randall Sq, Providence, RI 02904-2709 |
| Nadine S Hewamudalige | Family Medicine | The Providence Community Health Centers Inc. | 239 Cranston St, Providence, RI 02907-2406 |
| Stanley Block | Allergy/immunology | The Providence Community Health Centers Inc. | 375 Allens Ave, Providence, RI 02905-5010 |
| Sonal Patel | Family Medicine | The Providence Community Health Centers Inc. | 1 Warren Way, Providence, RI 02905-5000 |
| Erick R Soria Galvarro Duran | Internal Medicine | The Providence Community Health Centers Inc. | 375 Allens Ave, Providence, RI 02905-5010 |
| Tariq K Malik | Internal Medicine | The Providence Community Health Centers Inc. | 375 Allens Ave, Providence, RI 02905-5010 |
| Street Address |
239 CRANSTON ST |
| City | PROVIDENCE |
| State | RI |
| Zip | 02907-2406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nadine S Hewamudalige | Family Medicine | The Providence Community Health Centers Inc. | 239 Cranston St, Providence, RI 02907-2406 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Emilio Rodriguez-peris | Internal Medicine | 655 Broad St, Suite 201, Providence, RI 02907-1444 | |
| Stephanie L Hopkinson | Physical Therapy | Providence Physical Therapy Associates, Inc. | 655 Broad St, Providence, RI 02907-1444 |
| Ann Marie Craffey Duchesne | Physical Therapy | Providence Physical Therapy Associates, Inc. | 655 Broad St, Providence, RI 02907-1444 |
| Walter J Scott | Physical Therapy | Providence Physical Therapy Associates, Inc. | 655 Broad St, Providence, RI 02907-1444 |
| Sarah J Rodriguez-beerman | Clinical Social Worker | 270 Elmwood Ave, Providence, RI 02907-1524 | |
| Arianna H Iannuccilli | Chiropractic | 560 Elmwood Ave, Providence, RI 02907-1836 |
| City | PROVIDENCE |
| Zip Code | 02907 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | PROVIDENCE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Mofoluso O Agbelese.
| 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.