DR. ETTALEE SAMEK PASS (NPI# 1275576241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275576241 |
| Entity Type | Individual |
| Full Name | DR. ETTALEE SAMEK PASS |
| Credential | PH.D. |
| Practice Address |
29 Manor Rd Smithtown NY 11787-2714 |
| Mailing Address |
29 Manor Rd Smithtown NY 11787-2752 |
| Practice Telephone | 6312658873 |
| Practice Fax Number | 6317515287 |
| Mailing Telephone | 6312658873 |
| Mailing Fax Number | 6317515287 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2010-02-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
011597 | NY | Behavioral Health & Social Service Providers |
| Street Address |
29 MANOR RD |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-2714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114157385 | Dev R Chitkara M.d. P.C. | Otolaryngology | 29 Manor Rd, Smithtown, NY 11787-2752 | 2009-07-21 |
| 1982712105 | Dev R Chitkara | Otolaryngology | 29 Manor Rd, Smithtown, NY 11787-2714 | 2006-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
| Find all providers in zip 11787 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366796005 | Sunrise Psychology, Pllc | Psychologist | 363 Route 111 Ste 102, Smithtown, NY 11787-4750 | 2012-11-02 |
| 1609191840 | Vanessa Fonseca Gomes | Psychologist | 811 W Jericho Tpke, 106e, Smithtown, NY 11787-3232 | 2010-03-31 |
| 1356540462 | Alexis Provetto | Psychologist | 190 Pond View Ln, Smithtown, NY 11787-5200 | 2007-07-17 |
| 1023136231 | Mark Lawrence Dayboch | Psychologist | 119 Fifty Acre Rd S, Smithtown, NY 11787-2034 | 2007-03-26 |
| 1811065451 | Bruce David Friedin | Psychologist | 39 New Mill Rd, Smithtown, NY 11787-3323 | 2006-12-01 |
| 1609957091 | Norman J Kanter | Psychologist | 199 East Main Street, Suite 1, Smithtown, NY 11787-2892 | 2006-10-18 |
| 1821178476 | Zvi Steve Yadin | Psychologist | 21 Redwood Ln, Smithtown, NY 11787-2718 | 2006-10-17 |
| 1720183486 | Robert H Meyer | Psychologist | 85 Wesleyan Road, Smithtown, NY 11787-3012 | 2006-09-14 |
| 1487762670 | Simon A. Zysman | Psychologist | 278 E Main St, Smithtown, NY 11787-2920 | 2006-08-28 |
| 1942246335 | Ephraim Biblow | Psychologist | 269 F East Main Street, Smithtown, NY 11787-2322 | 2006-06-22 |
| Find all providers in SMITHTOWN | ||||
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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.