PROF. TRACI CONRAD MANKUTA (NPI# 1295142339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295142339 |
| Entity Type | Individual |
| Full Name | PROF. TRACI CONRAD MANKUTA |
| Other Name | MS. TRACI GABRIELLE CONRAD |
| Credential | MAED |
| Practice Address |
30 Woodlake Dr E Woodbury NY 11797-2317 |
| Practice Telephone | 5168022767 |
| Practice Fax Number | 5164844150 |
| Mailing Telephone | 5168022767 |
| Mailing Fax Number | 5164844150 |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 842527 | NY | Other Service Providers |
| Street Address |
30 WOODLAKE DR E |
| City | WOODBURY |
| State | NY |
| Zip Code | 11797-2317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508480757 | Melissa Beth Goldstein | Social Worker | 69 Aspen Drive West, Woodbury, NY 11797 | 2020-06-03 |
| 1023654985 | Stephanie Silberman | Social Worker | 136 Woodbury Rd Ste 103, Woodbury, NY 11797 | 2019-11-25 |
| 1225692304 | Patricia L Topper | Technician/Technologist | Optics Plus, 8285 Jericho Tpke, Woodbury, NY 11797 | 2019-04-24 |
| 1972040715 | Vicki Stogiannos | Counselor | 136 Woodbury Rd Ste L4, Woodbury, NY 11797 | 2017-01-31 |
| 1801225917 | Melissa Messer | Early Intervention Provider Agency | 108 Chestnut Lane, Woodbury, NY 11797 | 2013-11-08 |
| 1205174497 | Town Total Health, LLC | Pharmacy | 415 Crossways Park Drive, Suite A, Woodbury, NY 11797 | 2013-01-22 |
| 1750644878 | Shahrzad Bagheri | Specialist | 322 Anchorage Drive, Woodbury, Woodbury, New York, NY 11797 | 2012-06-22 |
| 1700171865 | Town Total Compounding Centers, LLC | Pharmacy | 415 Crossways Park Dr, Suite B, Woodbury, NY 11797 | 2011-06-16 |
| 1023316247 | Marnie Marissa Morabito | Speech-Language Pathologist | 72 Southwoods Road, Woodbury, NY 11797 | 2011-03-11 |
| 1114229838 | Malcolm Berger | Physical Therapy Assistant | 122 Southwoods Rd, Woodbury, NY 11797 | 2010-12-01 |
| Find all providers in zip 11797 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023662251 | Eva Frances Siegel | Specialist | 7 The Brae, Woodbury, NY 11797-2813 | 2019-07-25 |
| 1811455082 | Jenny Levinson | Specialist | 16 Fox Hollow Rd, Woodbury, NY 11797-1612 | 2019-03-06 |
| 1366921827 | Matt Dutton | Specialist | 1 Highpoint Ct, Woodbury, CT 06798-3228 | 2018-08-07 |
| 1073011284 | Dawn Lund Collins | Specialist | 13 Seward Dr, Woodbury, NY 11797-2608 | 2018-01-23 |
| 1720532591 | Stacy Silverman | Specialist | 16 Jennings Ct, Woodbury, NY 11797-3025 | 2016-08-10 |
| 1215386107 | Danielle Nicole Millman | Specialist | 3 Club House Ct, Woodbury, NY 11797-3028 | 2016-06-10 |
| 1568875078 | Robin Black | Specialist | 122 Woodlake Dr W, Woodbury, NY 11797-2311 | 2014-06-03 |
| 1396170577 | Lee Farrell Green | Specialist | 7663 Jericho Tpke, Woodbury, NY 11797-1703 | 2013-09-06 |
| 1043566359 | Susan Joy Rind | Specialist | 60 Dalor Ct, Woodbury, NY 11797-2908 | 2012-07-24 |
| 1417211178 | Shari Beth Mallor | Specialist | 28 Jennings Ln, Woodbury, NY 11797-3000 | 2012-06-27 |
| Find all providers in WOODBURY | ||||
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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.