MS. MELISSA FACKLER (NPI# 1215470257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215470257 |
| Entity Type | Individual |
| Full Name | MS. MELISSA FACKLER |
| Credential | MSN, RN, CCRN FNP |
| Practice Address |
1350 Northern Blvd Ste 202 Manhasset NY 11030 |
| Mailing Address |
1350 Northern Blvd Ste 202 Manhasset NY 11030-3013 |
| Practice Telephone | 5164823401 |
| Mailing Telephone | 5164823401 |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2019-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 687779-1 | NY | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
687779-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1350 Northern Blvd Ste 202, Manhasset, NY 11030 | 5164823401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689035644 | Melissa Fackler | Occupational Therapy Assistant | 18887 County Road 1150, Pioneer, OH 43554-9705 | 2016-03-17 |
| 1851945422 | Melissa Fackler | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2019-07-31 |
| Street Address |
1350 NORTHERN BLVD STE 202 |
| City | MANHASSET |
| State | NY |
| Zip Code | 11030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754126 | Diana Fox | Registered Nurse | 330 Community Drive, Manhasset, NY 11030 | 2019-05-02 |
| 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 |
| 1740589548 | Mary E Cheatham | Student in an Organized Health Care Education/Training Program | 400 Cmmunity Drive, Dental Center, Manhasset, NY 11030 | 2011-03-18 |
| Find all providers in zip 11030 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114276300 | Lorna Murrine Smith | Nurse Practitioner | 1129 Nthrn Blvd Ste 101, Manhasset, NY 11030-3022 | 2012-09-03 |
| 1609040138 | Priscilla Samuel | Nurse Practitioner | 300 Community Drive 9 Tower, Manhasset, NY 11030 | 2008-04-16 |
| 1356956726 | Talia Roffel | Nurse Practitioner | 300 Community Dr, Manhasset, NY 11030-3876 | 2020-09-12 |
| 1912511569 | Merzelie Casimir | Nurse Practitioner | 300 Community Dr, Manhasset, NY 11030-3876 | 2020-09-01 |
| 1639782469 | Blair M Whitley | Nurse Practitioner | 300 Community Dr, Manhasset, NY 11030-3816 | 2020-08-31 |
| 1093325052 | Robert Steve Santana | Nurse Practitioner | 300 Community Dr, Manhasset, NY 11030-3816 | 2020-08-05 |
| 1760009369 | Althea Webster-samuda | Nurse Practitioner | 330 Community Dr, Manhasset, NY 11030-3816 | 2020-06-29 |
| 1386283232 | Soledad Demicheri | Nurse Practitioner | 600 Community Dr, Manhasset, NY 11030-3802 | 2019-12-24 |
| 1992347504 | Kathie Lara Trimble | Nurse Practitioner | 1129 Northern Blvd Ste 101, Manhasset, NY 11030-3022 | 2019-10-15 |
| 1598313025 | Melodie Wanyi Lin | Nurse Practitioner | 300 Community Dr, Manhasset, NY 11030-3816 | 2019-08-28 |
| Find all providers in MANHASSET | ||||
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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.