MARICON BAS (NPI# 1083040075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083040075 |
| Entity Type | Individual |
| Full Name | MARICON BAS |
| Credential | N.P. |
| Practice Address |
3500 Sunrise Hwy Ste 124 Great River NY 11739-1001 |
| Mailing Address |
73 7th Ave N Huntington Station NY 11746-2208 |
| Practice Telephone | 6318540365 |
| Mailing Telephone | 6314705962 |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2019-11-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 643137 | NY | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
309238 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 480 Forest Ave, Locust Valley, NY 115602151 | 5167595406 |
| Street Address |
3500 SUNRISE HWY STE 124 |
| City | GREAT RIVER |
| State | NY |
| Zip Code | 11739-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871506055 | County of Suffolk | Home Health | 3500 Sunrise Hwy Ste 124, Great River, NY 11739-1001 | 2006-08-15 |
| 1316289895 | Cynthia Friedman | Preventive Medicine | 3500 Sunrise Hwy Ste 124, Great River, NY 11739-1001 | 2013-03-21 |
| 1285750737 | County of Suffolk | Public Health or Welfare | 3500 Sunrise Hwy Ste 124, Pob 9006, Great River, NY 11739-1001 | 2007-03-22 |
| 1497859615 | County of Suffolk | Home Health | 3500 Sunrise Hwy Ste 124, Great River, NY 11739-1001 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841273349 | Martin Arthur Hayman | Psychiatry & Neurology | 20 Redwood Dr, Great River, NY 11739-0626 | 2005-11-29 |
| 1033245832 | Podiatric and Surgical Wellcare of New York PC | Podiatrist | 295 Woodhollow Road, Great River, NY 11739-0719 | 2007-02-26 |
| 1508935669 | Judith L Miller | Case Management | 3500 Sunrise Hwy, Building 300, Great River, NY 11739-1001 | 2006-11-06 |
| 1639530082 | Suffolk County Department of Health | Clinic/Center | 3500 Sunrise Hwy, Great River, NY 11739-1001 | 2016-03-14 |
| 1578941068 | Suffolk County Department of Health Services | Clinic/Center | 3500 Sunrise Hwy, Great River, NY 11739-1001 | 2015-05-15 |
| 1578981106 | Doreen M Barclay | Case Manager/Care Coordinator | 3500 Sunrise Hwy, Building 300, Great River, NY 11739-1001 | 2014-04-01 |
| 1710030085 | Loyda M Rodriguez | Case Manager/Care Coordinator | 3500 Sunrise Hwy, Building 300, Great River, NY 11739-1001 | 2007-01-19 |
| 1164595054 | Dawn E Lewis | Case Manager/Care Coordinator | 3500 Sunrise Hwy, Building 300, Suite 403, Great River, NY 11739-1001 | 2006-11-16 |
| 1043382112 | Pauline A Fung | Case Manager/Care Coordinator | 3500 Sunrise Hwy, Building 300, Great River, NY 11739-1001 | 2006-11-14 |
| 1831495548 | Joan Alpers | Art Therapist | 83 Woodhollow Rd, Box 688, Great River, NY 11739-3000 | 2011-01-28 |
| Find all providers in zip 11739 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427871 | Tammie Kae Copp | Nurse Practitioner | 8266 Casson Rd, Lindley, NY 14858-9697 | 2020-11-08 |
| 1770184673 | Annette Virosami | Nurse Practitioner | 890 Trinity Ave Apt 8d, Bronx, NY 10456-7419 | 2020-11-06 |
| 1972104958 | Jonathan Dillera Nietes | Nurse Practitioner | 4411 Macnish St Apt 1g, Elmhurst, NY 11373-3609 | 2020-11-05 |
| 1407457088 | Sanjana Kumari | Nurse Practitioner | 62 Albertson Pl, Mineola, NY 11501-4601 | 2020-11-02 |
| 1780284927 | Hannah Catan | Nurse Practitioner | 473 W 158th St Apt 10, New York, NY 10032-5361 | 2020-10-27 |
| 1700486248 | Amandeep Kaur | Nurse Practitioner | 7638 270th St, New Hyde Park, NY 11040-1418 | 2020-10-26 |
| 1861091324 | Stacey M Jantsch | Nurse Practitioner | 8237 Cicero Mills Rd, Cicero, NY 13039-8344 | 2020-10-25 |
| 1871192468 | Adult Health Np House Calls, PC | Nurse Practitioner | 7954 Transit Rd # 134, Williamsville, NY 14221-4117 | 2020-10-23 |
| 1104425891 | Tze-hsuan Chao | Nurse Practitioner | 3916 Prince St Ste 257, Flushing, NY 11354-5367 | 2020-10-22 |
| 1992304968 | Nicholas Robinson | Nurse Practitioner | 295 Essjay, Williamsville, NY 14221 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | GREAT RIVER |
| Zip Code | 11739 |
Please comment or provide details below to improve the information on MARICON BAS.
| 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.