Douglas Berkley Tucker (NPI# 1588093843, PAC ID# 7315937778) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1588093843 |
| PAC ID by PECOS | 7315937778 |
| Professional Enrollment ID | I20040517000883 |
| Full Name | Douglas Berkley Tucker |
| Organization Legal Name | LORETTO REST REALTY CORPORATION |
| Address |
115 Creek Cir East Syracuse NY 13057-1369 |
| Phone Number | 3154133205 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF WISCONSIN MEDICAL SCHOOL |
| Graduation Year | 1984 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 3678560703 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 115 Creek Cir, East Syracuse, NY 13057-1369 | 3154133205 | LORETTO REST REALTY CORPORATION |
| Organization Legal Name | LORETTO REST REALTY CORPORATION |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Desta R Anthony | Nurse Practitioner | Loretto Rest Realty Corporation | 115 Creek Cir, East Syracuse, NY 13057-1369 |
| Street Address |
115 CREEK CIR |
| City | EAST SYRACUSE |
| State | NY |
| Zip | 13057-1369 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Desta R Anthony | Nurse Practitioner | Loretto Rest Realty Corporation | 115 Creek Cir, East Syracuse, NY 13057-1369 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Miles R Wiltse | Chiropractic | 6449 Kirkville Rd, East Syracuse, NY 13057-1600 | |
| David M Girardi | Optometry | 824 Franklin Park Dr, East Syracuse, NY 13057-1614 | |
| Mark Antosh | Obstetrics/gynecology | 824 Franklin Park Dr, East Syracuse, NY 13057-1642 | |
| Bruce J Jones | Clinical Social Worker | 160 Watertree Dr, E Syracuse, NY 13057-1921 | |
| Richard B Dixon | Chiropractic | 405 Kinne St, East Syracuse, NY 13057-2019 | |
| David Porter | Nurse Practitioner | St Josephs Hospital Health Center | 302 Upton St, East Syracuse, NY 13057-2308 |
| Ryan L D Amico | Podiatry | Ryan Damico Dpm Pllc | 7075 Manlius Ctr Rd, East Syracuse, NY 13057-2607 |
| Kathleen M Pyatak-hugar | Podiatry | Ryan Damico Dpm Pllc | 7075 Manlius Ctr Rd, East Syracuse, NY 13057-2607 |
| Donal M Erickson | Podiatry | Ryan Damico Dpm Pllc | 7075 Manlius Ctr Rd, East Syracuse, NY 13057-2607 |
| George T Cunningham | Chiropractic | 210 Old Bridge St, East Syracuse, NY 13057-2810 | |
| Find all physicians in zip 13057 | |||
| City | EAST SYRACUSE |
| Zip Code | 13057 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | EAST SYRACUSE + INTERNAL MEDICINE |
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| 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.