JANINE FETISOV (NPI# 1386039220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386039220 |
| Entity Type | Individual |
| Full Name | JANINE FETISOV |
| Credential | PA-C |
| Practice Address |
374 Stockholm St Brooklyn NY 11237-4006 |
| Mailing Address |
8633 Dexter Ct Woodhaven NY 11421-1028 |
| Practice Telephone | 7189637272 |
| Mailing Telephone | 3474449055 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 018517 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
374 STOCKHOLM ST |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11237-4006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700886322 | Wyckoff Heights Medical Center | General Acute Care Hospital | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2005-07-26 |
| 1285233189 | Camille I Del Pilar Rodriguez | General Practice | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-10-21 |
| 1972110096 | Wyckoff Heights Medical Center Laboratory Services | Clinical Medical Laboratory | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-09-24 |
| 1134734130 | Andre Cosmo Ruela | General Practice | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-09-15 |
| 1134732233 | Fehintola Orisamolu | Nurse Practitioner | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-08-28 |
| 1548871189 | Leonidha Duka | Student in an Organized Health Care Education/Training Program | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-08-16 |
| 1083225890 | Luis Carlos Moron Mercado | General Practice | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-08-14 |
| 1891305207 | Oyinem Odumah | Student in an Organized Health Care Education/Training Program | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-08-01 |
| 1609491646 | Bilyana Ristic | Dietitian, Registered | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-06-16 |
| 1881219061 | Victoria Lewis | Student in an Organized Health Care Education/Training Program | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2020-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194379644 | Giovanna Fiorella Ramirez Barbieri | Obstetrics & Gynecology | 374 Stockholm St, Brooklyn, Ny 11237, Brooklyn, NY 11237 | 2019-08-01 |
| 1013575554 | Miseon Kang | Counselor | Brooklyn Psychotherapy, 148 Wilson Ave, Brooklyn, NY 11237 | 2019-05-30 |
| 1023598943 | Kathryn Falk | Speech-Language Pathologist | Ps 376 C/o Kathryn Falk, 194 Harman Street, Brooklyn, NY 11237 | 2018-08-20 |
| 1437648870 | Dawn Tya Chapin | Student in an Organized Health Care Education/Training Program | Wyckoff Heights Medical Center, 374 Stockholm Street, Brooklyn, NY 11237 | 2018-05-01 |
| 1518410471 | Cameron Hetzler | Dentist | 374 Stockholm St., Brooklyn, NY 11237 | 2016-07-27 |
| 1215399043 | Rose R Capuz | Skilled Nursing Facility | 122 St Nicholas Avenue, Suite 2, Brooklyn, NY 11237 | 2016-03-22 |
| 1245695030 | Wyckoff Heights Dental Services, PC | Clinic/Center | Wyckoff Pediatric Care Center - 1411 Myrtle Avenue, Wyckoff Heights Dental Services, PC, Brooklyn, NY 11237 | 2015-12-21 |
| 1245615442 | Estefany Sanchez Mendez | Pediatrics | 374 Stockholm Street - Faculty Practice Dept, Wyckoff Professional and Medical Services, PC, Brooklyn, NY 11237 | 2015-07-29 |
| 1033507231 | Macarena Rufin | Counselor | 315 Wyckoff Ave., 6th Floor, Brooklyn, NY 11237 | 2014-12-23 |
| 1740691021 | Wyckoff Anesthesia and Medical Services, PC | Clinic/Center | 93-95 Wyckoff Ave, Wyckoff Anesthesia and Medical Services, PC, Brooklyn, NY 11237 | 2014-05-08 |
| Find all providers in zip 11237 | ||||
| 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 |
|---|---|---|---|---|
| 1952902256 | Billy Phuoctan Truong | Physician Assistant | 8832 18th Ave, Brooklyn, NY 11214-6002 | 2020-11-03 |
| 1700486560 | Jayanti Rao | Physician Assistant | 1059 Union St Apt 3g, Brooklyn, NY 11225-1268 | 2020-10-29 |
| 1376142737 | Amanda Shinall | Physician Assistant | 28 Old Fulton St Apt 4b, Brooklyn, NY 11201-6909 | 2020-10-18 |
| 1497353825 | Tsz Yan Soo | Physician Assistant | 8825 26th Ave Fl 2, Brooklyn, NY 11214-5408 | 2020-10-16 |
| 1164038907 | Emily Mai | Physician Assistant | 1956 W 9th St, Brooklyn, NY 11223-2548 | 2020-09-17 |
| 1497369342 | Krystal Renee Alexander | Physician Assistant | 2225 Ditmas Ave Apt 1a, Brooklyn, NY 11226-6993 | 2020-09-08 |
| 1578177390 | Celia Chen | Physician Assistant | 2628 E 18th St, Brooklyn, NY 11235-3659 | 2020-08-31 |
| 1669084547 | Peter Forman | Physician Assistant | 86 Saint Felix St, Brooklyn, NY 11217-3032 | 2020-08-20 |
| 1699383646 | Fabienne Mondelus | Physician Assistant | 715 E 108th St Apt 3c, Brooklyn, NY 11236-2929 | 2020-07-15 |
| 1508492729 | Esther Weitzner | Physician Assistant | 1195 E 12th St, Brooklyn, NY 11230-4811 | 2020-03-19 |
| Find all providers in BROOKLYN | ||||
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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.