PEDERSON-KRAG CENTER INC (NPI# 1013964170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013964170 |
| Entity Type | Organization |
| Organization Name | PEDERSON-KRAG CENTER INC |
| Other Organization Name | PEDERSON-KRAG CENTER, INC |
| Practice Address |
55 Horizon Dr Huntington NY 11743-4436 |
| Mailing Address |
142-02 20th Avenue 3rd Floor Flushing NY 11351 |
| Practice Telephone | 6319208000 |
| Practice Fax Number | 6319208167 |
| Mailing Telephone | 7185590555 |
| Mailing Fax Number | 7184457111 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2015-03-03 |
| Authorized Official Name | MS. JACQUELINE RIVERA-HERRERA (VP OF FINANCE FOR CLINICAL SERVICES) |
| Authorized Official Telephone | 3475424217 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | AETNA | 0007525706 | 01 |
| NY | 00337004 | 05 | |
| NY | BLUE CROSS | 002875 | 01 |
| NY | 01556532 | 05 | |
| NY | VALUE OPTIONS | 038080 | 01 |
| NY | RAILROAD MEDICARE | DA1829 | 01 |
| NY | 01819272 | 05 | |
| NY | BEACON HEALTH STRATEGIES | 1042840-8842 | 01 |
| NY | GHI | 3189305 | 01 |
| NY | AETNA | 0007155064 | 01 |
| NY | 01934014 | 05 | |
| NY | FIDELIS | 040403001029 | 01 |
| NY | 02717417 | 05 | |
| NY | VYTRA | 11662 | 01 |
| NY | OXFORD | ANC1285 | 01 |
| NY | BLUE CROSS | W02691 | 01 |
| NY | AETNA | 0007632069 | 01 |
| NY | BLUE CROSS | 001728 | 01 |
| Other Name | Type Code |
|---|---|
| PEDERSON-KRAG CENTER, INC | Other Name - Individual/Organization |
| Street Address |
55 HORIZON DR |
| City | HUNTINGTON |
| State | NY |
| Zip Code | 11743-4436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811988363 | Cathy Jo Lore | Psychiatry & Neurology | 55 Horizon Dr, Huntington, NY 11743-4436 | 2005-11-03 |
| 1811595937 | Breanna Hardy | Student in an Organized Health Care Education/Training Program | 55 Horizon Dr, Huntington, NY 11743-4436 | 2020-10-12 |
| 1598377061 | Athena Amelia Innes | Counselor | 55 Horizon Dr, Huntington, NY 11743-4436 | 2020-08-17 |
| 1295364453 | Jairo Antonio Martinez | Student in an Organized Health Care Education/Training Program | 55 Horizon Dr, Huntington, NY 11743-4436 | 2020-04-08 |
| 1710512579 | David Mark Chermak | Student in an Organized Health Care Education/Training Program | 55 Horizon Dr, Huntington, NY 11743-4436 | 2020-03-11 |
| 1871130377 | Nicole E Azzue | Student in an Organized Health Care Education/Training Program | 55 Horizon Dr, Huntington, NY 11743-4436 | 2019-12-03 |
| 1457995763 | James Cherry | Social Worker | 55 Horizon Dr, Huntington, NY 11743-4436 | 2019-10-30 |
| 1447801063 | Amber Marie Lennon | Case Manager/Care Coordinator | 55 Horizon Dr, Huntington, NY 11743-4436 | 2019-09-25 |
| 1063063543 | Stephanie Michelle Sampayo | Student in an Organized Health Care Education/Training Program | 55 Horizon Dr, Huntington, NY 11743-4436 | 2019-09-25 |
| 1962052191 | Vanessa C Smith | Licensed Vocational Nurse | 55 Horizon Dr, Huntington, NY 11743-4436 | 2019-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896477 | Peter C Gaal | Behavioral Analyst | 47 N. Woodhull Road, 2nd Floor, Huntington, NY 11743 | 2019-11-25 |
| 1902389299 | Taylor Bliss Dambrosio | Early Intervention Provider Agency | 38 Carnegie Ave, Huntington, NY 11743 | 2018-09-12 |
| 1639601750 | Speech and Hearing Services | Clinic/Center | 17 Brooks Ave Unit1, Huntington, NY 11743 | 2017-03-29 |
| 1174983456 | Helene Falcone | Registered Nurse | 264 W. 22nd St., Oakwood Primary Center, Hunt., NY 11743 | 2016-03-01 |
| 1124499470 | Thomas Hlenski | Social Worker | 4 Richard Lane, Huntington, NY 11743 | 2015-10-13 |
| 1174921308 | Jeanne Ginsberg | Counselor | 81 Knollwood Avenue, Huntington, NY 11743 | 2014-12-22 |
| 1770980534 | Emily Ann Sombke | Physician Assistant | 249 Manor Rd., Huntington, NY 11743 | 2014-11-21 |
| 1881096162 | Applied Health Chiropractic | Chiropractor | 12 Ash Pl, Huntington, NY 11743 | 2014-09-18 |
| 1265857643 | Ccs Medical Practice, Pllc | Public Health or Welfare | 17 Southdown Road, Huntington, NY 11743 | 2014-02-21 |
| 1255760682 | Ekaterina Femminella | Acupuncturist | 181 Main St Ste 105, Huntington, NY 11743 | 2013-11-06 |
| Find all providers in zip 11743 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1366446817 | University Physicians & Surgeons, Inc. | Clinic/Center | 1600 Medical Center Dr, Ste B500, Huntington, WV 25701-3656 | 2005-06-10 |
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| City | HUNTINGTON |
| Zip Code | 11743 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.