Brook A Gram (NPI# 1740321090, PAC ID# 8325285166) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1740321090 |
| PAC ID by PECOS | 8325285166 |
| Professional Enrollment ID | I20130514000712 |
| Full Name | Brook A Gram |
| Organization Legal Name | MARCO R CORALLO DO LLC |
| Address |
18586 5th St Beloit OH 44609-9799 |
| Phone Number | 3309383333 |
| Gender | F |
| Graduation Year | 2006 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1052212792 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360131 | ALLIANCE COMMUNITY HOSPITAL |
| 360185 | SALEM REGIONAL MEDICAL CENTER |
| 360070 | MERCY MEDICAL CENTER |
| 360064 | ST ELIZABETH YOUNGSTOWN HOSPITAL |
| 360084 | AULTMAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 18586 5th St, Beloit, OH 44609-9799 | 3309383333 | MARCO R CORALLO DO LLC |
| Organization Legal Name | MARCO R CORALLO DO LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marco Rosario Corallo | Endocrinology | Marco R Corallo Do LLC | 18586 5th St, Beloit, OH 44609-9799 |
| Krista Rubosky | Physician Assistant | Marco R Corallo Do LLC | 18586 5th St, Beloit, OH 44609-9799 |
| Street Address |
18586 5TH ST |
| City | BELOIT |
| State | OH |
| Zip | 44609-9799 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marco Rosario Corallo | Endocrinology | Marco R Corallo Do LLC | 18586 5th St, Beloit, OH 44609-9799 |
| Krista Rubosky | Physician Assistant | Marco R Corallo Do LLC | 18586 5th St, Beloit, OH 44609-9799 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Corallo | Dermatology | David J. Corallo, D.o. | 18586 W 5th St, Beloit, OH 44609-9799 |
| Nicole Darty | Physician Assistant | David J. Corallo, D.o. | 18586 W 5th St, Beloit, OH 44609-9799 |
| City | BELOIT |
| Zip Code | 44609 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | BELOIT + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Brook A Gram.
| 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.