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Physician Last Name Physician First Name Physician Middle Name License Number License Type Effective Date Date Updated Year of Birth
Chisholm David R. 162699 MD 05/17/2024 05/14/2024 1957
Sokhon Kozhaya C. 225564 MD 05/21/2024 05/14/2024 1968
Rudis Steven P. 215322 MD 05/21/2024 05/14/2024 1962
Glickman Scott G. 249936 DO 03/22/2024 05/14/2024 1972
Campasano Vincent J. 228987 MD 05/21/2024 05/14/2024 1974
Jones Ryan T. 026201 PA 05/09/2024 05/02/2024 1985
Lape Jeffrey 000489 PA 05/08/2024 05/01/2024 1952
Delrosario Gonzalez Nancy 113372 MD 05/03/2024 04/30/2024 1940
Delrosario-Gonzalez Nancy 113372 MD 05/03/2024 04/30/2024 1940
Williams Dwight M. 152712 MD 04/05/2024 04/25/2024 1952
White Xavier 198793 MD 03/18/2024 04/23/2024 1948
Baram Vadim 230500 MD 04/29/2024 04/22/2024 1967
Ali Syed Masood 162447 MD 04/29/2024 04/22/2024 1940
Ross Jonathan M. 127593 MD 04/29/2024 04/22/2024 1945
Gordon Linda R. 220666 MD 04/04/2024 04/18/2024 1971
Stoll Andrew M. 174508 MD 04/24/2024 04/17/2024 1958
Nelson Alan J. 125202 MD 04/24/2024 04/17/2024 1945
Santiago Julian A. 019319 PA 04/24/2024 04/17/2024 1993
Venerus Bryan J. 229527 MD 04/23/2024 04/16/2024 1961
Isaac George B. 204255 MD 04/19/2024 04/12/2024 1960
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