JACLYN SARA DIMATTEI (NPI# 1093238222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093238222 |
| Entity Type | Individual |
| Full Name | JACLYN SARA DIMATTEI |
| Credential | NP |
| Practice Address |
75 Landing Meadow Rd Smithtown NY 11787-1124 |
| Mailing Address |
269 Radio Ave Miller Place NY 11764-3528 |
| Practice Telephone | 6313604700 |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
308286 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 33 Terryville Rd, Port Jefferson Station, NY 117761331 | 6314394300 |
| Street Address |
75 LANDING MEADOW RD |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-1124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467466581 | James Robert Powell | Internal Medicine | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2006-07-27 |
| 1235684127 | Long Island Select Healthcare, Inc. | Clinic/Center | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2016-08-20 |
| 1447603501 | Long Island Select Healthcare, Inc. | Clinic/Center | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2016-07-13 |
| 1801130141 | Catherine M Cardello | Registered Nurse | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2012-11-26 |
| 1124270012 | Celenia Hines | Speech-Language Pathologist | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2008-10-22 |
| 1063664126 | Steven Rossi | Speech-Language Pathologist | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2008-10-21 |
| 1396910626 | Developmental Disabilities Institute | Clinic/Center | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2008-04-28 |
| 1437324076 | Developmental Disabilities Institure | Clinic/Center | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2008-04-24 |
| 1689793366 | Kimberly Mullen James | Psychologist | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2007-03-27 |
| 1679623896 | Nancy J Fortin | Nurse Practitioner | 75 Landing Meadow Rd, Opti Health Care, Smithtown, NY 11787 | 2007-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
| Find all providers in zip 11787 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346790755 | Catherine Audus | Nurse Practitioner | 60 Lindron Ave, Smithtown, NY 11787-1661 | 2016-10-10 |
| 1891120572 | Jennifer Jane Alfano | Nurse Practitioner | 50 New York 25a, Smithtown, NY 11787 | 2013-09-12 |
| 1003466780 | Heather Caligiuri | Nurse Practitioner | 50 New York Ave # 25a, Smithtown, NY 11787-3448 | 2019-09-16 |
| 1427512763 | Joseph Rosario | Nurse Practitioner | 1056 W Jericho Tpke, Smithtown, NY 11787-3212 | 2019-01-30 |
| 1063917136 | Diane Grassi | Nurse Practitioner | 285 E Main St, Smithtown, NY 11787-2978 | 2018-03-29 |
| 1699201970 | Beena Jacob | Nurse Practitioner | 285 Middle Country Rd, Smithtown, NY 11787-2978 | 2017-05-05 |
| 1144751934 | Michael Cresson | Nurse Practitioner | 50 New York Ave # 25a, Cardiac Cath Lab, Smithtown, NY 11787-3448 | 2017-03-23 |
| 1164964755 | Ashley Kump | Nurse Practitioner | 1045 W Jericho Tpke, Smithtown, NY 11787-3205 | 2016-11-14 |
| 1447624655 | Kimberly Finnegan | Nurse Practitioner | 50 Route 25a, Smithtown, NY 11787-1348 | 2015-11-25 |
| 1780949776 | Charlene Benjamin | Nurse Practitioner | 257 E Middle Country Rd, Smithtown, NY 11787-2807 | 2012-07-06 |
| Find all providers in SMITHTOWN | ||||
Please comment or provide details below to improve the information on JACLYN SARA DIMATTEI.
| 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.