DR. CAROLYN A. WILLIS (NPI# 1376595215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376595215 |
| Entity Type | Individual |
| Full Name | DR. CAROLYN A. WILLIS |
| Credential | M.D. |
| Practice Address |
54 New Hyde Park Rd Garden City NY 11530-3909 |
| Mailing Address |
6819 Loubet St Forest Hills NY 11375-5732 |
| Practice Telephone | 5164881313 |
| Practice Fax Number | 5164883449 |
| Mailing Telephone | 7188462991 |
| Mailing Fax Number | 5164883449 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2007-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 226705 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477189124 | Carolyn Willis | Behavior Technician | 12650 E Briarwood Ave, Suite 207, Centennial, CO 80112-6792 | 2020-03-13 |
| Street Address |
54 NEW HYDE PARK RD |
| City | GARDEN CITY |
| State | NY |
| Zip Code | 11530-3909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881245876 | Katherine Ann Murphy | Physician Assistant | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2019-09-22 |
| 1609365352 | Andrew Thomas Clark | Registered Nurse | 54 New Hyde Park Rd, Garden City, NY 11530 | 2018-05-08 |
| 1306187711 | Eran Sykes | Registered Nurse | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2013-03-09 |
| 1255603817 | Shelley Hannah Fox | Nurse Practitioner | 54 New Hyde Park Rd, Garden City, NY 11530 | 2012-01-29 |
| 1265727333 | Michael Steven Mclemore | Pathology | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2011-06-16 |
| 1366742744 | Renee Drobinski | Physician Assistant | 54 New Hyde Park Rd, Garden City, NY 11530-3948 | 2010-11-01 |
| 1598820698 | Joseph Onorato M.d., P.C. | Specialist | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-12-27 |
| 1942362215 | Kelly Ledermann | Nurse Practitioner | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-12-14 |
| 1013084763 | Dina Marie Puglissi | Specialist | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-11-29 |
| 1992882773 | Joseph Onorato | Dermatology | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144850207 | Ellen Jay Palacio Mabatid | Physical Therapist | 66 New Hyde Park, Garden City, NY 11530 | 2020-01-16 |
| 1255991022 | Rubin Anesthesia Pain Management, Pllc | Anesthesiology | 1103 Stewart Avenue, Suite 300, Garden City, NY 11530 | 2019-06-14 |
| 1144793720 | Jack Doby Garden City, LLC | Eyewear Supplier (Equipment, not the service) | Jack Doby Garden City, LLC, 928 Old Country Road, Garden City, NY 11530 | 2019-01-07 |
| 1386135051 | Granger & Sahasra | Dentist | 1103 Stewart Avenue Suite 104, Garden City, NY 11530 | 2018-05-29 |
| 1598262537 | Suzanne P. Reid-bradshaw | Specialist | Kidz Therapy, 300 Garden City Plaza, Garden City, NY 11530 | 2018-04-06 |
| 1972021129 | Nicole Maria Gaudino | Nurse Practitioner | One South Avenue, Waldo Hall, Garden City, NY 11530 | 2017-09-07 |
| 1619495645 | Christine Scheppa | Registered Nurse | 225 Brompton Rd South, Garden City South, NY 11530 | 2017-08-30 |
| 1699290981 | Deborah Ann Pontosky | Registered Nurse | 104 Fifth Street, Garden City, NY 11530 | 2017-08-08 |
| 1932648748 | Tahmina Jahir | Student in an Organized Health Care Education/Training Program | 15 Hilton Ave, Garden City, NY 11530 | 2017-02-14 |
| 1598209173 | Dino Michelli | Specialist | 300 Garden City Plaza, Ste 350, Kidz Therapy/ Gayle E. Kligman Therapeutic Resources, Garden City, NY 11530 | 2016-12-15 |
| Find all providers in zip 11530 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831212265 | Carina Rizzo | Dermatology | 877 Stewart Ave Ste 27, Garden City, NY 11530-4803 | 2007-04-09 |
| 1093788416 | Frank J Demento | Dermatology | 520 Franklin Avenue, Suite 229, Garden City, NY 11530-5878 | 2006-02-08 |
| 1174918973 | Eric Sorenson | Dermatology | 877 Stewart Ave Ste 27, Garden City, NY 11530-4803 | 2015-03-30 |
| 1073953410 | Chelsea K Duggan | Dermatology | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2013-06-30 |
| 1467622456 | Irene Lu | Dermatology | 520 Franklin Ave, Suite 229, Garden City, NY 11530-5801 | 2008-03-05 |
| 1215083365 | Frank Demento, Md & Associates,pc | Dermatology | 520 Franklin Ave, Suite 229, Garden City, NY 11530-5801 | 2007-01-25 |
| 1992882773 | Joseph Onorato | Dermatology | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-11-01 |
| 1922196617 | Jonathan Beschloss | Dermatology | 54 New Hyde Park Rd, Garden City, NY 11530-3909 | 2006-10-10 |
| 1073533634 | Peter E O'neill | Dermatology | 226 7th St, Suite 103, Garden City, NY 11530-5723 | 2006-07-19 |
| 1750355434 | Tina K Funt | Dermatology | 229 7th St, Suite 105, Garden City, NY 11530-5766 | 2006-02-17 |
| Find all providers in GARDEN CITY | ||||
| City | GARDEN CITY |
| Zip Code | 11530 |
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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.