Thaddeus Herliczek (NPI# 1053457721, PAC ID# 5395818413) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1053457721 |
| PAC ID by PECOS | 5395818413 |
| Professional Enrollment ID | I20080723000523 |
| Full Name | Thaddeus Herliczek |
| Organization Legal Name | RHODE ISLAND MEDICAL IMAGING |
| Address |
195 Collyer St Providence RI 02904-1869 |
| Phone Number | 4014322520 |
| Gender | M |
| Medical School | UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL |
| Graduation Year | 2002 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 8022097815 |
| Number of Group Practice Members | 93 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 410007 | RHODE ISLAND HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 195 Collyer St, Providence, RI 02904-1869 | 4014322520 | RHODE ISLAND MEDICAL IMAGING |
| Organization Legal Name | RHODE ISLAND MEDICAL IMAGING |
| Physicians | 93 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marcelle Piccolello | Diagnostic Radiology | Rhode Island Medical Imaging | 1351 S County Trl Rte 2, E Greenwich, RI 02818-5079 |
| Mark A Geist | Diagnostic Radiology | Rhode Island Medical Imaging | 20 Catamore Blvd, E Providence, RI 02914-1204 |
| Robert C Ward | Diagnostic Radiology | Rhode Island Medical Imaging | 1351 S County Trl Rte 2, E Greenwich, RI 02818-5079 |
| Glenn Tung | Diagnostic Radiology | Rhode Island Medical Imaging | 1351 S County Trl Rte 2, E Greenwich, RI 02818-5079 |
| David K Gunasti | Diagnostic Radiology | Rhode Island Medical Imaging | 1351 S County Trl Rte 2, E Greenwich, RI 02818-5079 |
| Guarav Jindal | Diagnostic Radiology | Rhode Island Medical Imaging | 1351 S County Trl Rte 2, E Greenwich, RI 02818-5079 |
| Heather Hardie | Diagnostic Radiology | Rhode Island Medical Imaging | 211 Park St, Attleboro, MA 02703-3143 |
| Hanan I Khalil | Diagnostic Radiology | Rhode Island Medical Imaging | 1351 S County Trl Rte 2, E Greenwich, RI 02818-5079 |
| David Neumann | Diagnostic Radiology | Rhode Island Medical Imaging | 1351 S County Trl Rte 2, E Greenwich, RI 02818-5079 |
| Linda Donegan | Diagnostic Radiology | Rhode Island Medical Imaging | 1351 S County Trl Rte 2, E Greenwich, RI 02818-5079 |
| Street Address |
195 COLLYER ST |
| City | PROVIDENCE |
| State | RI |
| Zip | 02904-1869 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dawn Drake | Nurse Practitioner | University Surgical Associates, Inc. | 195 Collyer St, Suite 302, Providence, RI 02904-1869 |
| Jo Ann M Moore | Nurse Practitioner | Brown Urology, Inc. | 195 Collyer St, Providence, RI 02904-1869 |
| Harry M Iannotti | Urology | Brown Urology, Inc. | 195 Collyer St, Suite 104, Providence, RI 02904-1869 |
| Jacqueline M Joubert | Nurse Practitioner | Brown Urology, Inc. | 195 Collyer St, Suite 201, Providence, RI 02904-1869 |
| Sun H Ahn | Diagnostic Radiology | Rhode Island Medical Imaging | 195 Collyer St, Providence, RI 02904-1869 |
| Sunhe Fusco | Nurse Practitioner | University Surgical Associates, Inc. | 195 Collyer St, Suite 302, Providence, RI 02904-1869 |
| Jennifer C Fuller | Physician Assistant | Rhode Island Medical Imaging | 195 Collyer St, Providence, RI 02904-1869 |
| Sivamainthan Vithiananthan | General Surgery | University Surgical Associates, Inc. | 195 Collyer St, Suite 302, Providence, RI 02904-1869 |
| Cristina Ruggieri | Physician Assistant | University Surgical Associates, Inc. | 195 Collyer St, Suite 302, Providence, RI 02904-1869 |
| Arthur Wang-yan Wong | Urology | Brown Urology, Inc. | 195 Collyer St, Suite 201, Providence, RI 02904-1869 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert B Patterson | Vascular Surgery | 486 Silver Spring St, Providence, RI 02904-1556 | |
| Nishit Shah | Colorectal Surgery (proctology) | University Surgical Associates, Inc. | 208 Collyer St, Suite 302, Providence, RI 02904-1560 |
| Laurel A Gay | Physician Assistant | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Adam Klipfel | Colorectal Surgery (proctology) | University Surgical Associates, Inc. | 208 Collyer St, Suite 302, Providence, RI 02904-1560 |
| Fredric V Christian | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Roger D Raymond | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Michelle Kristen Finkelman | Nurse Practitioner | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Olivia Macaskill | Nurse Practitioner | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Susan P Emaus | Physician Assistant | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Kenneth S Korr | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Providence, RI 02904-1560 |
| Find all physicians in zip 02904 | |||
| City | PROVIDENCE |
| Zip Code | 02904 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | PROVIDENCE + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Thaddeus Herliczek.
| 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.