ST. NICHOLAS PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC (NPI# 1033631064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033631064 |
| Entity Type | Organization |
| Organization Name | ST. NICHOLAS PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC |
| Practice Address |
1264 Saint Nicholas Ave Ste A New York NY 10033-7263 |
| Mailing Address |
304 Wainwright Dr Northbrook IL 60062-1900 |
| Practice Telephone | 7183011100 |
| Practice Fax Number | 2242468042 |
| Mailing Telephone | 8472571244 |
| Mailing Fax Number | 2242468042 |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2017-07-11 |
| Authorized Official Name | FLORA KATSNELSON (OWNER/DIRECTOR) |
| Authorized Official Telephone | 8472571244 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036113246 | 05 |
| Street Address |
1264 SAINT NICHOLAS AVE STE A |
| City | NEW YORK |
| State | NY |
| Zip Code | 10033-7263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265046940 | William F Ryan Community Health Center Inc | Clinic/Center | 154 Wadsworth Avenue, New York, NY 10033 | 2020-09-01 |
| 1063048627 | Lori Cinar | Speech-Language Pathologist | 544 Fort Washington Avenue, New York, NY 10033 | 2020-03-16 |
| 1245885953 | Beth Feldman | Occupational Therapist | 93 Bennett Ave, New York, NY 10033 | 2019-08-08 |
| 1053971903 | Daniel Harmeyer | Registered Nurse | 560 W 168th St, New York, Ny 10032, New York, NY 10033 | 2019-06-13 |
| 1770141038 | Rio Espiritu | Physical Therapist | 601 West 182nd.street, New York, NY 10033 | 2019-06-03 |
| 1154986255 | Gira Ileana Graciano Mireles | Student in an Organized Health Care Education/Training Program | 355 Bart Avenue, Department of Medicine Villa Bldg 1st Floor, New York, NY 10033 | 2019-05-03 |
| 1386140812 | Han Acupuncture | Acupuncturist | 701 W 177th Street, Suite 001, New York, NY 10033 | 2018-04-03 |
| 1023524956 | Kyong Su Han | Acupuncturist | 701 West 177th St, #001, New York, NY 10033 | 2017-12-14 |
| 1609380336 | Divine Luxury Transportation Inc | Non-emergency Medical Transport (VAN) | 360 Audubon Avenue, New York, NY 10033 | 2017-11-16 |
| 1174042683 | Kseniya Yershova | Psychologist | 66 Pinehurst Ave, 1a, New York, NY 10033 | 2017-09-15 |
| Find all providers in zip 10033 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366914483 | Star Veins Centers PC | Surgery | 225 W 35th St Frnt 2, New York, NY 10001-1904 | 2018-12-31 |
| 1417340134 | Washington Heights Medical of New York LLC | Surgery | 4159 Broadway, New York, NY 10033-3702 | 2015-03-05 |
| 1154613214 | Bakir Mohammed Altai | Surgery | 606 W 146th St, New York, NY 10031-4305 | 2011-05-09 |
| 1245547124 | Milton Waner Md, Pllc | Surgery | 126 W 60th St, New York, NY 10023-7402 | 2010-09-13 |
| 1114097094 | Windsor Ting, Md | Surgery | 128 Mott St Ste 701, New York, NY 10013-5575 | 2006-11-08 |
| 1538255336 | Robert J Mulcare Md PC | Surgery | 3 East 74th St, Suite 1e, New York, NY 10021-2604 | 2006-10-05 |
| 1619061926 | Moshe N Haimov | Surgery | 12 E 97th St, New York, NY 10029-6918 | 2006-10-03 |
| 1346331519 | Richard W Schutzer | Surgery | 161 Fort Washington Ave Ste 532, New York, NY 10032-3729 | 2006-09-27 |
| 1659470219 | Danielle R Bajakian | Surgery | 161 Ft Washingtn Ave Fl 5, Columbia University- Dept of Surgey, New York, NY 10032-3729 | 2006-09-21 |
| 1568473700 | Stephen G Hurst | Surgery | 1264 Saint Nicholas Ave Ste B, New York, NY 10033-7263 | 2006-08-11 |
| Find all providers in NEW YORK | ||||
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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.