MR. IVAN IVANOVICH DRAZEK (NPI# 1285814616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285814616 |
| Entity Type | Individual |
| Full Name | MR. IVAN IVANOVICH DRAZEK |
| Credential | PA-C |
| Practice Address |
103 Viceroy Dr Camillus NY 13031-3001 |
| Practice Telephone | 3158824923 |
| Mailing Telephone | 3158824923 |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2008-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1074875 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
103 VICEROY DR |
| City | CAMILLUS |
| State | NY |
| Zip Code | 13031-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194361337 | Marsha Reedy | Registered Nurse | Baldwinsville Schools, 29 East Oneida Street, Baldwinsville, NY 13031 | 2019-11-22 |
| 1821632167 | Romans Soltani Dentistry, Pllc | Dentist | 5426 W. Genesee Street, Camillus, NY 13031 | 2019-10-30 |
| 1174178859 | Abigail Marie Brunner | Nurse Practitioner | 208 Township Blvd, Suite 100, Camillus, NY 13031 | 2019-08-08 |
| 1649779547 | Claire Isaacson | Counselor | 6000 W Genesee St Ste 400, Camillus, NY 13031 | 2018-02-06 |
| 1811426190 | At Home Independent Living, Inc. | In Home Supportive Care | 4464 Milton Ave, Syracuse, NY 13031 | 2017-06-08 |
| 1548643471 | Podiatry Services of Central New York, PC | Podiatrist | 4912 West Genesee Street, Camillus, NY 13031 | 2015-07-09 |
| 1023497203 | New York Anesthesiology Medical Specialties, PC | Pain Medicine | 5417 West Genesee Street, Suite 1, Camillus, NY 13031 | 2015-05-21 |
| 1194130377 | Costco Wholesale Corporation | Pharmacy | 120 Township Blvd, Camillus, NY 13031 | 2014-06-25 |
| 1487084976 | Todd Ray | Social Worker | 6000 W Genesee St, Camillus, NY 13031 | 2013-11-19 |
| 1093045155 | Rebecca Mae Goal Carroll | Physical Therapist | 5417 W Genesee St, Camillus, NY 13031 | 2010-01-12 |
| Find all providers in zip 13031 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437348125 | Anne Marie Schonewald | Physician Assistant | 5700 W Genesee St Ste 124, Camillus, NY 13031-3206 | 2007-10-18 |
| 1194819656 | Rita E Macdonald | Physician Assistant | 5700 West Genesee St., Camillus, NY 13031 | 2006-10-02 |
| 1336601384 | Jane Choi | Physician Assistant | 5415 W Genesee St Ste 301, Camillus, NY 13031 | 2019-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821026 | Victoria Yunaev | Physician Assistant | 7203 166th St, Fresh Meadows, NY 11365-3237 | 2020-11-05 |
| 1811598857 | Brittany Christine Androsko | Physician Assistant | 1769 Union St Fl 2, Niskayuna, NY 12309-6311 | 2020-11-05 |
| 1164023172 | Betina Charlotte Apostol Nuguid | Physician Assistant | 1730 Central Park Ave Ste 3p, Yonkers, NY 10710-4905 | 2020-11-05 |
| 1023619129 | Anna Leigh Vonck | Physician Assistant | 2 Executive Park Dr Ste 2, Albany, NY 12203-3700 | 2020-11-04 |
| 1952902256 | Billy Phuoctan Truong | Physician Assistant | 8832 18th Ave, Brooklyn, NY 11214-6002 | 2020-11-03 |
| 1205437621 | Jason Patrick Feak | Physician Assistant | 6338 Falls Blvd, Chittenango, NY 13037-8799 | 2020-11-03 |
| 1437750742 | Drew James Mitchell | Physician Assistant | 58 Old Bedford Rd, Goldens Bridge, NY 10526-1000 | 2020-11-03 |
| 1306446125 | Julie Mcphillips | Physician Assistant | 961 W Kaisertown Rd, Montgomery, NY 12549-2317 | 2020-10-30 |
| 1487254330 | Thomas J Nagel | Physician Assistant | 57 Montgomery Road, Fort Montgomery, NY 10922 | 2020-10-29 |
| 1700486560 | Jayanti Rao | Physician Assistant | 1059 Union St Apt 3g, Brooklyn, NY 11225-1268 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
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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.