DEBRA IWANOW (NPI# 1184240889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184240889 |
| Entity Type | Individual |
| Full Name | DEBRA IWANOW |
| Credential | ATC, CSCS |
| Practice Address |
169 Riverside Dr Binghamton NY 13905-4246 |
| Mailing Address |
29 Delview Ter Delhi NY 13753-1056 |
| Practice Telephone | 6075921225 |
| Mailing Telephone | 6075921225 |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AL3019 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
001234 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NEW YORK STATE LICENSE | 001234 | 01 |
| FL | FLORIDA STATE LICENSE | AL3019 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 712 Farm To Market Rd, Endwell, NY 137601128 | 6075921225 |
| Street Address |
169 RIVERSIDE DR |
| City | BINGHAMTON |
| State | NY |
| Zip Code | 13905-4246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548253446 | Advanced Radiology Services, Pllc | Radiology | 169 Riverside Dr, Binghamton, NY 13905-4246 | 2005-08-25 |
| 1639777451 | Ceirra Robin Tennant | Nurse Practitioner | 169 Riverside Dr, Binghamton, NY 13905-4198 | 2020-10-14 |
| 1427674555 | Emily Elizabeth Krol | Physician Assistant | 169 Riverside Dr, Binghamton, NY 13905-4246 | 2020-06-24 |
| 1124642921 | Daniel Fitzpatrick | Registered Nurse | 169 Riverside Dr, Binghamton, NY 13905-4246 | 2020-06-08 |
| 1255955100 | Robin Underwood | Registered Nurse | 169 Riverside Dr, Binghamton, NY 13905-4198 | 2020-06-05 |
| 1447872817 | Kelly Ann Yale-suda | Registered Nurse | 169 Riverside Dr, Binghamton, NY 13905-4246 | 2020-05-08 |
| 1548880917 | Mahdi Shafiq | Student in an Organized Health Care Education/Training Program | 169 Riverside Dr, Binghamton, NY 13905-4246 | 2020-04-25 |
| 1669092672 | Thien-duy Brandon Tran | Student in an Organized Health Care Education/Training Program | 169 Riverside Dr, Binghamton, NY 13905-4246 | 2020-04-20 |
| 1164042313 | Benjamin Levi Kaplan | Student in an Organized Health Care Education/Training Program | 169 Riverside Dr, Binghamton, NY 13905-4246 | 2020-04-17 |
| 1861012163 | Brian Somsook | Student in an Organized Health Care Education/Training Program | 169 Riverside Dr, Binghamton, NY 13905-4198 | 2020-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689222820 | Pamela K Wheaton | Counselor | 40 Front Sreet, Suite K, Binghamton, NY 13905 | 2019-08-30 |
| 1417422593 | Justin William Arnold | Massage Therapist | 1235 Front St, Suite 4, Binghamton, NY 13905 | 2018-10-04 |
| 1366886632 | Lalor Family Dental Pllc | Dentist | 1216 Upper Front Street, Binghamton, NY 13905 | 2013-04-17 |
| 1699015172 | Radharani Mohanty | Pediatrics | 1 Ely Park Blvd - M4, Binghamton, NY 13905 | 2013-02-21 |
| 1710260344 | Michelle L. Rease | Registered Nurse | 40 Front St. Suite C, C/o Riverside Anesthesia, Binghamton, NY 13905 | 2011-09-20 |
| 1508173337 | John D Newman | Registered Nurse | 169 Riverside Dr., Our Lady of Lourdes Hospital, Binghamton, NY 13905 | 2010-08-31 |
| 1073758330 | Jennifer Lynn Kolesar | Pharmacist | Cvs Pharmacy 68 Main St., Binghamton, NY 13905 | 2008-12-15 |
| 1245355155 | Tara Jayant Belsare | Psychiatry & Neurology | 38 Riverside Drive, Binghamton, NY 13905 | 2007-03-20 |
| 1659411866 | State of New York | Intermediate Care Facility, Mentally Retarded | Glenwood Rd, Binghamton, NY 13905 | 2007-02-07 |
| 1528133956 | Judith Tanzer | Social Worker | 35 Front Street, Binghamton, NY 13905 | 2006-11-21 |
| Find all providers in zip 13905 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457864852 | Jansen Shea | Specialist/Technologist | Po Box 6000, Binghamton, NY 13902-6000 | 2017-11-08 |
| 1306251350 | Kara Shanay Gorgos | Specialist/Technologist | 6 Marion Ct, Binghamton, NY 13903-6730 | 2014-06-29 |
| 1073658068 | Wendy Ann Bucci | Specialist/Technologist | 4 Oakridge Dr, Binghamton, NY 13903-2125 | 2007-02-20 |
| 1972536613 | Noel A. Zeh | Specialist/Technologist | 4000 Vestal Parkway E, Binghamton, NY 13902 | 2006-07-08 |
| 1801850615 | Jon R. Smith | Specialist/Technologist | 907 Upper Front St, Binghamton, NY 13905-1328 | 2006-04-17 |
| 1053830653 | Taylor Jon Hall | Specialist/Technologist | 169 Riverside Dr, Binghamton, NY 13905-4246 | 2017-09-14 |
| 1780035477 | Caitlin Ely | Specialist/Technologist | 33 Mitchell Ave, Binghamton, NY 13903-1642 | 2016-06-24 |
| 1578608576 | Jennifer Lynn Reis | Specialist/Technologist | 4400 Vestal Parkway, Events Center, Binghamton, NY 13902-6000 | 2007-02-20 |
| 1245375252 | Elyse E Clark | Specialist/Technologist | 4400 Vestal Parkway, Binghamton University Events Center, Binghamton, NY 13902-6000 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779309 | Jonathan Edwards | Specialist/Technologist | 39 Monty St, Plattsburgh, NY 12901-3702 | 2020-10-30 |
| 1245830207 | Skyler Lauren Cirillo | Specialist/Technologist | 1000 Hempstead Turnpike, Hempstead, NY 11549-0001 | 2020-10-29 |
| 1790384410 | Gina Siracusano | Specialist/Technologist | 630 Mastic Rd Ste 4, Mastic Beach, NY 11951-1020 | 2020-10-23 |
| 1134728504 | Corinne Edwards | Specialist/Technologist | 3606 Nutt Rd, Jamestown, NY 14701-9432 | 2020-10-18 |
| 1720687163 | Theresa A Trump | Specialist/Technologist | 7 Mapleline Rd, Ballston Lake, NY 12019-1589 | 2020-10-17 |
| 1235738667 | Erica Michalski | Specialist/Technologist | 157 Hillpine Rd, Cheektowaga, NY 14227-2261 | 2020-10-17 |
| 1396344743 | Jared Russom | Specialist/Technologist | 13 Brookview Ave., Delmar, NY 12054 | 2020-10-17 |
| 1720686231 | Leighann Buzzard | Specialist/Technologist | 277 Forbes Ave, Tonawanda, NY 14150-4705 | 2020-10-16 |
| 1861090367 | Jake Savino | Specialist/Technologist | 185 Oak Ave, Staten Island, NY 10306-4002 | 2020-10-15 |
| 1992303572 | Elise Fitzsimmons | Specialist/Technologist | 9 Laker Hall, Oswego, NY 13126 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | BINGHAMTON |
| Zip Code | 13905 |
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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.