ED180, INC (NPI# 1154723559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154723559 |
| Entity Type | Organization |
| Organization Name | ED180, INC |
| Other Organization Name | ED180 EATING DISORDER TREATMENT PROGRAMS |
| Practice Address |
300 Garden City Plz Suite 312 Garden City NY 11530-3302 |
| Practice Telephone | 5162803544 |
| Practice Fax Number | 5164142544 |
| Mailing Telephone | 5162803544 |
| Mailing Fax Number | 5164142544 |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |
| Authorized Official Name | JEFFREY R DESARBO (DIRECTOR) |
| Authorized Official Telephone | 5162803544 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Ed180 Eating Disorder Treatment Programs | Other Name - Individual/Organization |
| Street Address |
300 GARDEN CITY PLZ SUITE 312 |
| City | GARDEN CITY |
| State | NY |
| Zip Code | 11530-3302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073547147 | Jeffrey R Desarbo | Psychiatry & Neurology | 300 Garden City Plz, Garden City, NY 11530-3302 | 2006-07-11 |
| 1861008369 | Adrienne Kelly | Specialist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-09-20 |
| 1396359444 | Kristin Summers Gallucci | Occupational Therapist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-09-06 |
| 1497369771 | Thomas Vincent Whalen | Physical Therapist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-09-03 |
| 1326651423 | Lauren Sustad | Specialist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-08-28 |
| 1407469083 | Daniella Latino | Speech-Language Pathologist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-08-25 |
| 1699387720 | Nicole M. Mcnair | Counselor | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-08-19 |
| 1083222103 | Suzanne Levy | Counselor | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-07-14 |
| 1831707082 | Joanna Nicole Marullo | Case Manager/Care Coordinator | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-07-14 |
| 1285255331 | Darienne Bergman | Psychologist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144850207 | Ellen Jay Palacio Mabatid | Physical Therapist | 66 New Hyde Park, Garden City, NY 11530 | 2020-01-16 |
| 1255991022 | Rubin Anesthesia Pain Management, Pllc | Anesthesiology | 1103 Stewart Avenue, Suite 300, Garden City, NY 11530 | 2019-06-14 |
| 1144793720 | Jack Doby Garden City, LLC | Eyewear Supplier (Equipment, not the service) | Jack Doby Garden City, LLC, 928 Old Country Road, Garden City, NY 11530 | 2019-01-07 |
| 1386135051 | Granger & Sahasra | Dentist | 1103 Stewart Avenue Suite 104, Garden City, NY 11530 | 2018-05-29 |
| 1598262537 | Suzanne P. Reid-bradshaw | Specialist | Kidz Therapy, 300 Garden City Plaza, Garden City, NY 11530 | 2018-04-06 |
| 1972021129 | Nicole Maria Gaudino | Nurse Practitioner | One South Avenue, Waldo Hall, Garden City, NY 11530 | 2017-09-07 |
| 1619495645 | Christine Scheppa | Registered Nurse | 225 Brompton Rd South, Garden City South, NY 11530 | 2017-08-30 |
| 1699290981 | Deborah Ann Pontosky | Registered Nurse | 104 Fifth Street, Garden City, NY 11530 | 2017-08-08 |
| 1932648748 | Tahmina Jahir | Student in an Organized Health Care Education/Training Program | 15 Hilton Ave, Garden City, NY 11530 | 2017-02-14 |
| 1598209173 | Dino Michelli | Specialist | 300 Garden City Plaza, Ste 350, Kidz Therapy/ Gayle E. Kligman Therapeutic Resources, Garden City, NY 11530 | 2016-12-15 |
| Find all providers in zip 11530 | ||||
| Taxonomy Code | 103TP2701X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Group Psychotherapy |
| Definition to come... |
| Notes: [1/1/2007: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942425483 | Teresa Rene Sutherlin | Psychologist | 531 Campus View St, Garden City, KS 67846-7904 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679190144 | C.a.r.e. Nutrition Consultants, LLC | Psychologist | 120 Breckenridge Rd, Mahopac, NY 10541-1200 | 2020-07-01 |
| 1437663192 | Michelle Patricia Flores | Psychologist | 9000 Old River Rd Bldg 26, Marcy, NY 13403-3043 | 2017-11-16 |
| 1134648876 | Tyler Mendoza | Psychologist | 347 5th Ave Rm 703a, New York, NY 10016-5036 | 2017-09-13 |
| 1013430560 | Sabrina M Jhanwar | Psychologist | 333 E 43rd St Ofc 1, New York, NY 10017-4831 | 2017-07-17 |
| 1386004273 | Lauren Saltus | Psychologist | 1115 Merillon St, Uniondale, NY 11553-1221 | 2016-03-04 |
| 1437494648 | Medical Practice Ny PC | Psychologist | 6923 168th St, Fresh Meadows, NY 11365-3213 | 2012-11-29 |
| 1215115431 | Eric Niles Weissman | Psychologist | 18 Scotchtown Ave, Goshen, NY 10924 | 2008-02-11 |
| 1891981403 | Dorian Edward Poole | Psychologist | 8149 242 St, Queens, NY 11426 | 2007-09-18 |
| 1073734349 | Pearl A Weinstein | Psychologist | 35 Hillside Road, Farmingdale, NY 11735-1917 | 2007-05-02 |
| 1083835953 | Associates In Psychotherapy | Psychologist | 135 E 50 St, Suite 106, Nyc, NY 10022 | 2007-05-01 |
| Find all providers with the same taxonomy | ||||
| City | GARDEN CITY |
| Zip Code | 11530 |
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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.