THERESA M DOMAGOLA (NPI# 1184676322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184676322 |
| Entity Type | Individual |
| Full Name | THERESA M DOMAGOLA |
| Credential | ACNP C |
| Practice Address |
101 Canal Landing Blvd Suite 8 Rochester NY 14626-5109 |
| Mailing Address |
2365 S Clinton Ave Suite 100 Rochester NY 14618-2663 |
| Practice Telephone | 5852397300 |
| Practice Fax Number | 5852277723 |
| Mailing Telephone | 5854425320 |
| Mailing Fax Number | 5854425526 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2013-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
430210 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MCR | 70008ARA6884 | 01 | |
| NY | 02601196 | 05 |
| Street Address |
101 CANAL LANDING BLVD SUITE 8 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14626-5109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154753 | Patrick Daley | Physician Assistant | 101 Canal Landing Blvd, Rochester, NY 14626 | 2016-10-05 |
| 1417095076 | Nathan Ritter | Internal Medicine | 101 Canal Landing Blvd, Suite 8, Rochester, NY 14626-5109 | 2007-02-02 |
| 1720173339 | Katherine Scrimgeour Hoose | Nurse Practitioner | 101 Canal Landing Blvd, Suite 8, Rochester, NY 14626-5109 | 2006-10-03 |
| 1972615755 | Ryan Connell | Internal Medicine | 101 Canal Landing Blvd, Suite 8, Rochester, NY 14626-5109 | 2006-08-31 |
| 1740392539 | Ryan Hoefen | Internal Medicine | 101 Canal Landing Blvd, Suite 8, Rochester, NY 14626-5109 | 2006-08-31 |
| 1902851702 | Sarah E Taylor | Internal Medicine | 101 Canal Landing Blvd, Suite 8, Rochester, NY 14626-5109 | 2006-05-23 |
| 1598710279 | Tejan Patel | Internal Medicine | 101 Canal Landing Blvd, Suite #8, Rochester, NY 14626-5109 | 2006-05-23 |
| 1821040601 | Joan L Thomas | Internal Medicine | 101 Canal Landing Blvd, Suite #8, Rochester, NY 14626-5109 | 2006-05-17 |
| 1780636514 | Robert R Vannozzi | Internal Medicine | 101 Canal Landing Blvd, Suite #8, Rochester, NY 14626-5109 | 2006-05-17 |
| 1952353492 | Irina S Sanberg | Physician Assistant | 101 Canal Landing Blvd, Suite 8, Rochester, NY 14626-5109 | 2006-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760978084 | Elizabeth M Neenan | Nurse Practitioner | 105 Canal Landing Blvd. Suite 1, Rochester, NY 14626 | 2018-07-10 |
| 1811488737 | Anthony Richard Mesolella | Dentist | 2081 W Ridge Rd Ste 204, Rochester, NY 14626 | 2018-05-26 |
| 1285157370 | Heather Kate Byam | Nurse Anesthetist, Certified Registered | 280 Mill Road, Rochester, NY 14626 | 2017-07-20 |
| 1710415039 | Abner O De Los Santos | Dentist | 120 Erie Canal Dr Ste 150, Rochester, NY 14626 | 2017-05-31 |
| 1609308709 | Ulfat Shafiq | Dentist | 1100 Long Pond Rd Ste 115, Greece, NY 14626 | 2017-03-29 |
| 1174982953 | S.a.v.o.c L.l.c | Preferred Provider Organization | 2833 West Ridge Road, Pearle Vision Ridgemont Plaza Suite 'a', Rochester, NY 14626 | 2016-02-22 |
| 1700244357 | Kerri Anne Sawyer | Registered Nurse | 82 Southridge Drive, Rochester, NY 14626 | 2016-02-10 |
| 1518398106 | Braces of Greece | Exclusive Provider Organization | 770 Fetzner Rd., Rochester, NY 14626 | 2013-12-06 |
| 1477983443 | Amy Pawlyk | Licensed Practical Nurse | 116 Annie Lane, Rochester, NY 14626 | 2013-11-12 |
| 1689911208 | Kathleen Zimmerman | Occupational Therapist | 1555 Long Pond Rd., 4th Floor, Rochester, NY 14626 | 2013-01-16 |
| Find all providers in zip 14626 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548820954 | Jacqueline Michalko | Nurse Practitioner | 601 Elmwood Ave # 619-736, Rochester, NY 14642-0001 | 2019-06-18 |
| 1306331459 | Lindsay Ann Watkins | Nurse Practitioner | 601 Elmwood Ave Unit 716, Rochester, NY 14642-0002 | 2018-06-29 |
| 1588064083 | Brittany A Swift | Nurse Practitioner | 32 Keswick Rd, Rochester, NY 14609-3309 | 2014-09-03 |
| 1891091575 | Rebecca Tucker | Nurse Practitioner | 610 Elmwood Ave, Rochester, NY 14642 | 2011-01-28 |
| 1669567871 | Maureen Walden | Nurse Practitioner | 11 Whitehall Road, Rochester, NH 03867-3297 | 2006-10-04 |
| 1700970225 | Joanne Vandevalk Clements | Nurse Practitioner | 601 Elmwood Ave, Box 604, Preadmission Evaluation Center, Rochester, NY 14642 | 2006-10-02 |
| 1891803177 | Kristine Elisabeth Miller | Nurse Practitioner | 1600 Chili Ave, Ste 200, Rochester, NY 14624 | 2006-08-28 |
| 1619083292 | Darby Leyden | Nurse Practitioner | 601 Elmwood Ave # 619-10, Rochester, NY 14642-0001 | 2006-08-23 |
| 1861497182 | Krista L. Prinzi | Nurse Practitioner | 2365 Clinton Ave S, Rochester, NY 14618-2663 | 2005-06-14 |
| 1891394037 | Thomas Smith | Nurse Practitioner | 1555 Long Pond Rd, Rochester, NY 14626-4122 | 2020-10-20 |
| Find all providers in ROCHESTER | ||||
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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.