DOMENICA CORRADO (NPI# 1255677480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255677480 |
| Entity Type | Individual |
| Full Name | DOMENICA CORRADO |
| Credential | RN, FNP |
| Practice Address |
Mather Hospital 75 N Country Road Port Jefferson NY 11777 |
| Mailing Address |
124 Pond Rd Coram NY 11727-3746 |
| Practice Telephone | 6314731320 |
| Mailing Telephone | 8452835311 |
| Enumeration Date | 2012-12-16 |
| Last Update Date | 2019-07-09 |
| NPI Deactivation Date | 06/07/2016 |
| NPI Reactivation Date | 2019-06-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 645874 | NY | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
344016 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
MATHER HOSPITAL 75 N COUNTRY ROAD |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609416940 | Jacqueline J. Bishop | Nurse Practitioner | 200 Belle Terre Rd Ste 200, Port Jefferson, NY 11777-1928 | 2020-01-15 |
| 1942578968 | Christopher Ljucovic | Nurse Practitioner | 620 Belle Terre Rd Ste 2, Port Jefferson, NY 11777-2500 | 2011-12-05 |
| 1770193096 | Vanessa Lynn Uhr | Nurse Practitioner | 125 Oakland Ave Ste 203, Port Jefferson, NY 11777-2130 | 2020-08-02 |
| 1023679503 | Katlyn Ann Conville | Nurse Practitioner | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2019-06-25 |
| 1215495700 | Staci Marie Clabough | Nurse Practitioner | 635 Belle Terre Rd Ste 209, Port Jefferson, NY 11777-1987 | 2019-03-04 |
| 1356807242 | Justine Marie Schleiffelder | Nurse Practitioner | 75 N Country Rd, Port Jefferson, NY 11777-2190 | 2019-02-15 |
| 1659858744 | Deanna Amber Spence | Nurse Practitioner | 120 N Country Rd, Port Jefferson, NY 11777-2604 | 2018-07-23 |
| 1598151151 | Keri Michele Rolls | Nurse Practitioner | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2015-04-10 |
| 1295150050 | Elizabeth Ann Cohen | Nurse Practitioner | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2014-03-03 |
| 1790095123 | Renata J. Sterne | Nurse Practitioner | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2010-10-19 |
| Find all providers in PORT JEFFERSON | ||||
| City | PORT JEFFERSON |
| Zip Code | 11777 |
Please comment or provide details below to improve the information on DOMENICA CORRADO.
| 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.