PAUL J MATTIS (NPI# 1114066792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114066792 |
| Entity Type | Individual |
| Full Name | PAUL J MATTIS |
| Credential | PHD |
| Practice Address |
400 Community Dr Manhasset NY 11030-3815 |
| Mailing Address |
972 Brush Hollow Rd 4th Floor Westbury NY 11590-1740 |
| Practice Telephone | 5165623054 |
| Practice Fax Number | 5165622830 |
| Mailing Telephone | 5168765555 |
| Mailing Fax Number | 5168765539 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2019-10-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01708781 | 05 |
| Street Address |
400 COMMUNITY DR |
| City | MANHASSET |
| State | NY |
| Zip Code | 11030-3815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255311403 | Halana Rothbort | Psychiatry & Neurology | 400 Community Dr, Manhasset, NY 11030-3815 | 2006-01-21 |
| 1457974107 | Diana Elena Dalmasi | Family Medicine | 400 Community Dr, Manhasset, NY 11030-3815 | 2020-05-28 |
| 1871137646 | Jinu Mathew Thomas | Nurse Practitioner | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-11-04 |
| 1144863051 | Elishia Kathleen Crumwell-mack | Internal Medicine | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-10-23 |
| 1477102234 | Lawrence Lau | Transplant Surgery | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-09-05 |
| 1619520376 | Cassandra L Jonaitis | Nurse Practitioner | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-07-22 |
| 1932751757 | Danielle Lauren Cabral | Pharmacist | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-07-11 |
| 1629542691 | Julie Lauren Pennetti | Nurse Practitioner | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-01-14 |
| 1568949600 | Michelle H Min | Pharmacist | 400 Community Dr, Manhasset, NY 11030 | 2018-07-22 |
| 1194246710 | Gabrielle Nicole Plaia | Pharmacist | 400 Community Dr, Manhasset, NY 11030-3815 | 2017-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754126 | Diana Fox | Registered Nurse | 330 Community Drive, Manhasset, NY 11030 | 2019-05-02 |
| 1215470257 | Melissa Fackler | Registered Nurse | 1350 Northern Blvd Ste 202, Manhasset, NY 11030 | 2016-11-23 |
| 1821443391 | Sarah Javdan | Family Medicine | 800 Community Dr Ste 206, Manhasset, NY 11030 | 2016-05-03 |
| 1891167458 | Stacie Thaw Lcsw Pllc | Social Worker | 115 Park Ave., Manhasset, NY 11030 | 2015-10-22 |
| 1538547971 | Aarti Kumar | Podiatrist | 535 Plandome Rd # 2, Manhasset, NY 11030 | 2015-05-18 |
| 1073933586 | Rachel Durante | Occupational Therapist | 600 Community Drive, Manhasset, NY 11030 | 2014-04-23 |
| 1831436435 | Anesthesia Care, P.C. | General Practice | 565 Plandome Road, Manhasset, NY 11030 | 2013-01-16 |
| 1821350091 | Sylvia Yoonsun Kim | Pharmacist | 139 Vanderbilt Ave, Manhasset, NY 11030 | 2012-06-13 |
| 1699062588 | Rod Stern | Dentist | 444 Community Dr Ste 201, Manhasset, NY 11030 | 2011-06-30 |
| 1558654798 | Alexandria Pace Kress | Speech-Language Pathologist | 31 Circle Dr, Manhasset, NY 11030 | 2011-05-20 |
| Find all providers in zip 11030 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174181382 | Kayla Whearty | Clinical Neuropsychologist | 1554 Northern Blvd Ste 204, Manhasset, NY 11030-3054 | 2019-06-03 |
| 1265675359 | Kristen Hope Demertzis | Clinical Neuropsychologist | 1554 Northern Blvd., Transitions, 3rd Floor, Manhasset, NY 11030-3006 | 2009-04-20 |
| 1992875041 | William Matos | Clinical Neuropsychologist | Nsuh-dept of Psychiatry, 300 Community Drive, Manhasset, NY 11030 | 2006-11-08 |
| 1023505435 | Erica Pauline Meltzer | Clinical Neuropsychologist | 1554 Northern Blvd, Manhasset, NY 11030-3006 | 2018-04-20 |
| 1801918677 | Henry Anthony Malone | Clinical Neuropsychologist | 535 Plandome Rd, Manhasset, NY 11030-1961 | 2007-04-04 |
| 1114086121 | John Wayne Lazar | Clinical Neuropsychologist | 300 Community Dr, Manhasset, NY 11030-3816 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609408046 | Nassau Neuropsychological Services, Pllc | Clinical Neuropsychologist | 386 S Oyster Bay Rd, Hicksville, NY 11801-3509 | 2020-02-04 |
| 1922656875 | Kouros Emami | Clinical Neuropsychologist | 525 East 71st St., 5th Floor, New York, NY 10021 | 2019-09-03 |
| 1720633860 | Emily Kurlansik | Clinical Neuropsychologist | 300 W 55th St Apt 6c, New York, NY 10019-5164 | 2019-08-06 |
| 1447729595 | Beth Krone | Clinical Neuropsychologist | 6818 Bay Cliff Ter, Brooklyn, NY 11220-5114 | 2018-11-19 |
| 1750860144 | Linda Cristina Calderon | Clinical Neuropsychologist | 635 W 165th St Rm 633a, New York, NY 10032-3724 | 2018-08-07 |
| 1366936585 | Nicole Feirsen | Clinical Neuropsychologist | 3307 Bainbridge Ave Fl 1, Bronx, NY 10467-2850 | 2018-06-20 |
| 1306349493 | Abhishek Jaywant | Clinical Neuropsychologist | 525 E 68th St # F-1699g, New York, NY 10065-4870 | 2018-03-14 |
| 1043718505 | Elsa Lee | Clinical Neuropsychologist | 25418 Northern Blvd Ste 3, Little Neck, NY 11362-1451 | 2018-01-30 |
| 1154829000 | Alice Brown Brandwein | Clinical Neuropsychologist | 445 Park Ave Fl 2, New York, NY 10022-8649 | 2018-01-25 |
| 1841707643 | Jennifer Martinez | Clinical Neuropsychologist | 1 3rd Ave, Mineola, NY 11501-4299 | 2018-01-03 |
| Find all providers with the same taxonomy | ||||
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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.