MICHELE J FAGAN (NPI# 1255417523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255417523 |
| Entity Type | Individual |
| Full Name | MICHELE J FAGAN |
| Credential | MD |
| Practice Address |
Mmc - Peds. Emergency Medicine 111 East 210th Street Bronx NY 10467 |
| Mailing Address |
165 Bennett Ave Apt. 4g New York NY 10040-4013 |
| Practice Telephone | 7189205312 |
| Mailing Telephone | 7189205312 |
| Mailing Fax Number | 7187986485 |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
212908 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235400151 | Michele L Fagan | Behavioral Analyst | 2 Wendover Ct, Bedminster, NJ 07921-1405 | 2012-01-24 |
| 1073780912 | Michele N Fagan | Speech-Language Pathologist | 1201 E 15th St, Suite 304, Plano, TX 75074-6238 | 2008-05-09 |
| Street Address |
MMC - PEDS. EMERGENCY MEDICINE 111 EAST 210TH STREET |
| City | BRONX |
| State | NY |
| Zip Code | 10467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366528630 | Paul Chambers | Pediatrics | Mmc - Peds. Emergency Medicine, 111 East 210th Street, Bronx, NY 10467 | 2006-10-30 |
| 1558432930 | Diana King | Pediatrics | Mmc - Peds. Emergency Medicine, 111 East 210th Street, Bronx, NY 10467 | 2006-11-10 |
| 1477623684 | Michal M Gombos | Pediatrics | Mmc - Peds. Emergency Medicine, 111 East 210th Street, Bronx, NY 10467 | 2006-11-08 |
| 1679659528 | Ruby E Rivera | Pediatrics | Mmc - Peds. Emergency Medicine, 111 East 210th Street, Bronx, NY 10467 | 2006-10-31 |
| 1588740435 | Lorraine T Ronca | Pediatrics | Mmc - Peds. Emergency Medicine, 111 East 210th Street, Bronx, NY 10467 | 2006-10-31 |
| 1295811149 | Cary S Siegel | Pediatrics | Mmc - Peds. Emergency Medicine, 111 East 210th Street, Bronx, NY 10467 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535505 | Maxwell Ennist | Massage Therapist | 210 Bedford Park Blvd, Bronx, NY 10467 | 2020-10-09 |
| 1144854431 | Ny Metro Dental, PC | Dentist | 55 Mosholu Parkway North, Bronx, NY 10467 | 2020-02-26 |
| 1386277960 | Rhonda Ellen Nayberg | Occupational Therapist | Montefiore Medical Center Occupational Therapy Dept, 111 E 210 Street Ground Floor Blue Zone, Bronx, NY 10467 | 2020-02-21 |
| 1013568153 | Jaime Luis Betancourt | Nurse Practitioner | Sickle Cell Clinic, 3400 Bainbridge Avenue, Bronx, NY 10467 | 2019-09-20 |
| 1023662616 | Bronx Jewish Community Council Home Attendant Services | Home Health | 2930 Wallace Ave., Bronx, NY 10467 | 2019-07-31 |
| 1831755321 | Felix Medrano | Taxi | 3106 Webster Ave, Bronx, NY 10467 | 2019-05-10 |
| 1700363108 | Danaies Guzman | Occupational Therapist | 2410 Barker Avenue Apt 11a, Bronx, New York, NY 10467 | 2018-07-27 |
| 1538672175 | Carolina Duque-toro | Speech-Language Pathologist | 4251, 341 E 207th St, Bronx, NY 10467 | 2017-11-06 |
| 1255853727 | Jessica Perkiss | Social Worker | 750 Tilden St., Astor Services for Children and Families, Bronx, NY 10467 | 2017-07-17 |
| 1386166221 | Erica Santos | Licensed Practical Nurse | 3273 Parkside Place, Apt 5g, Bronx, NY 10467 | 2017-07-12 |
| Find all providers in zip 10467 | ||||
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518043884 | Waseem Hafeez | Pediatrics | Mmc - Emergency Medicine, 111 East 210th Street, Bronx, NY 10467 | 2006-10-30 |
| 1366528630 | Paul Chambers | Pediatrics | Mmc - Peds. Emergency Medicine, 111 East 210th Street, Bronx, NY 10467 | 2006-10-30 |
| 1851350730 | Carmen Lazala | Pediatrics | 2676b Grand Concourse, Bronx, NY 10458-4962 | 2006-03-21 |
| 1821507799 | Albert Abraham Mitta | Pediatrics | 234 E 149th St, Bronx, NY 10451-5504 | 2017-09-23 |
| 1649538968 | Nicole Constance O'connell | Pediatrics | 3415 Bainbridge Ave, Bronx, NY 10467-2403 | 2012-04-24 |
| 1316101793 | Anjana Vagarali Uppal | Pediatrics | 1400 Pelham Pkwy S, Building 6; Dept of Pediatric Emergency Medicine, Bronx, NY 10461-1138 | 2008-07-15 |
| 1831358472 | Kerrin C Depeter | Pediatrics | 1400 Pelham Pkwy S, Bronx, NY 10461-1138 | 2008-06-09 |
| 1629237813 | Czer Anthoney Enriquez Lim | Pediatrics | 1400 Pelham Pkwy S, 1b-25, Bronx, NY 10461-1138 | 2008-06-03 |
| 1245400035 | Christine Rizkalla | Pediatrics | 111 E 210th St, Pediatric Emergency Department, Bronx, NY 10467-2401 | 2008-03-07 |
| 1891909453 | Abigail Faulkner Nixon | Pediatrics | 1400 Pelham Pkwy S, Jacobi Medical Center, Dept of Pediatric Emergency Med, Bronx, NY 10461-1138 | 2007-05-10 |
| Find all providers in BRONX | ||||
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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.