MIADETTE PHENG-PHAL (NPI# 1073044616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073044616 |
| Entity Type | Individual |
| Full Name | MIADETTE PHENG-PHAL |
| Credential | NP-C |
| Practice Address |
269 Union St Lynn MA 01901-1314 |
| Practice Telephone | 7815813900 |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
RN2270203 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
269 UNION ST |
| City | LYNN |
| State | MA |
| Zip Code | 01901-1314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033111711 | Melinda D Jones | Nurse Practitioner | 269 Union St, Lynn, MA 01901-1314 | 2005-08-12 |
| 1245830900 | Angel Felix Rosado Mencia | Dentist | 269 Union St, Lynn, MA 01901-1314 | 2020-10-30 |
| 1114525342 | Nerla Batraville | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-10-09 |
| 1497352736 | Gaelle A Wagnac | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-10-08 |
| 1679170153 | Melissa Chenard | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-10-07 |
| 1174137665 | Stacey Marie Anzalone | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-09-02 |
| 1801409511 | Devin Green | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-08-24 |
| 1891306643 | Theresa Goretti | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-08-14 |
| 1306467972 | Aishetu Kutigi Abubakar | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-05-05 |
| 1508487505 | Jennifer Gonzalez | Registered Nurse | 269 Union St, Lynn, MA 01901-1314 | 2020-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427515923 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 173 Oxford Street, Lowel Level, Suite P, Lynn, MA 01901 | 2019-02-21 |
| 1730680125 | Sarah Sawulski | Registered Nurse | 269 Union Stree01901t, Lynn, MA 01901 | 2018-02-22 |
| 1184142895 | Adrienne Wood | Case Manager/Care Coordinator | 100 Willow Street, Lynn, MA 01901 | 2017-09-01 |
| 1831613199 | Marie Linda Yannaco-grant | Social Worker | 62 Market Street, Lynn, MA 01901 | 2017-07-28 |
| 1942723457 | Michael Xinyu Miao | Physical Therapy Assistant | 1 Market Street, 3rd Floor, Lynn, MA 01901 | 2017-07-18 |
| 1730544743 | Pediatric Dental Professionals LLC | Dentist | 391 Lynn Way, Bldg A, Lynn, MA 01901 | 2015-12-17 |
| 1346667748 | Emily G. Joseph | Social Worker | 112 Market Street, 2nd Floor, Lynn, MA 01901 | 2014-03-24 |
| 1548510621 | Serena M Smith | Counselor | 181 Union Street, Suite J, Lynn, MA 01901 | 2012-09-14 |
| 1043575624 | Timothy J Bossie | Optometrist | 20 Central Avenue, Lynn, MA 01901 | 2012-07-10 |
| 1689946923 | Lynn Dental Center | Dentist | 232 Union Street, Lynn, MA 01901 | 2012-02-02 |
| Find all providers in zip 01901 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497222574 | Elvira Minasyan | Nurse Practitioner | 225 Boston St, Lynn, MA 01904-3137 | 2018-10-26 |
| 1124594650 | Vania Ibacache | Nurse Practitioner | 269 Union St, Lynn, MA 01901-1314 | 2018-10-23 |
| 1710480793 | Philip Gawrys | Nurse Practitioner | 496 Lynnfield St, Lynn, MA 01904-1423 | 2018-03-15 |
| 1902316086 | Wangari Gathungu | Nurse Practitioner | 20 Central Ave, Lynn, MA 01901-1201 | 2017-10-03 |
| 1205378593 | Amie Lee Begin | Nurse Practitioner | 280 Union St, Lynn, MA 01901-1353 | 2016-11-17 |
| 1952772634 | Sarah Reddy | Nurse Practitioner | 37 Friend St, Lynn, MA 01902-3068 | 2015-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760082366 | Donna Josephine Remmes | Nurse Practitioner | 313 Franklin St, Wrentham, MA 02093-2405 | 2020-11-01 |
| 1912513714 | James Vincent Fournier | Nurse Practitioner | 50 Memorial Dr Ste 205, Leominster, MA 01453-2238 | 2020-09-17 |
| 1386259109 | Maureen Villars | Nurse Practitioner | 32 Orchard Hill Dr, Rutland, MA 01543-1778 | 2020-09-09 |
| 1639783780 | Patricia Varela | Nurse Practitioner | 48 Percival St, Dorchester, MA 02122-1992 | 2020-09-05 |
| 1578172243 | Felicia Mendonca | Nurse Practitioner | 21 Lands End Way, Swansea, MA 02777-2909 | 2020-07-28 |
| 1831716901 | Joan Tiano | Nurse Practitioner | 595 Pawtucket Blvd Ste 3, Lowell, MA 01854-2042 | 2020-07-06 |
| 1720609829 | Angelique Group | Nurse Practitioner | 4 Upland Woods Cir Unit 402, Norwood, MA 02062-3261 | 2020-04-29 |
| 1093341331 | Frew Fikru | Nurse Practitioner | 529 Washington Ave Apt 2, Revere, MA 02151-1962 | 2020-03-18 |
| 1376189084 | Dorcas Korir | Nurse Practitioner | 248 Pleasant St Unit 204, Methuen, MA 01844-7149 | 2019-11-18 |
| 1376194142 | Nicholas Davenport Biscardi | Nurse Practitioner | 6 Wells St, Gloucester, MA 01930-3423 | 2019-09-24 |
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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.