DR. RICHARD W GOTLIB (NPI# 1386623338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386623338 |
| Entity Type | Individual |
| Full Name | DR. RICHARD W GOTLIB |
| Credential | MD |
| Practice Address |
6080 Jericho Tpke Ste 102 Commack NY 11725-2850 |
| Practice Telephone | 6314864742 |
| Practice Fax Number | 6314864745 |
| Mailing Telephone | 6314864742 |
| Mailing Fax Number | 6314864745 |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 196722-1 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01921168 | 05 |
| Street Address |
6080 JERICHO TPKE STE 102 |
| City | COMMACK |
| State | NY |
| Zip Code | 11725-2850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346239738 | Mitchell Robert Ezrin | Chiropractor | 6080 Jericho Tpke, Suite 206, Commack, NY 11725-2850 | 2005-10-18 |
| 1871132175 | Laura Santiago | Behavioral Analyst | 6080 Jericho Tpke, Commack, NY 11725-2850 | 2020-01-03 |
| 1235770728 | Camille Serrano | Behavior Technician | 6080 Jericho Tpke, Commack, NY 11725-2850 | 2019-10-04 |
| 1851957302 | Michael Read | Massage Therapist | 6080 Jericho Tpke, Commack, NY 11725-2850 | 2019-05-09 |
| 1063956241 | Lauren Dolce | Nurse Practitioner | 6080 Jericho Tpke, Suite 314, Commack, NY 11725-2850 | 2016-12-07 |
| 1518400159 | Karen S. Tukman, Lcsw, PC | Social Worker | 6080 Jericho Tpke, Suite 304, Commack, NY 11725-2850 | 2016-11-30 |
| 1851840540 | Janine D'amico | Nurse Practitioner | 6080 Jericho Tpke, Commack, NY 11725-2850 | 2016-09-23 |
| 1649653270 | Virginia Mchale | Nurse Practitioner | 6080 Jericho Tpke, Suite 314, Commack, NY 11725-2850 | 2015-07-01 |
| 1063810752 | Julie Haussmann | Social Worker | 6080 Jericho Tpke, Commack, NY 11725-2850 | 2014-12-11 |
| 1144631987 | Shakira Shanker | Psychiatry & Neurology | 6080 Jericho Tpke, Commack, NY 11725-2850 | 2014-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699322131 | Amanda Grace Acebedo | Student in an Organized Health Care Education/Training Program | 785 Larkfield Rd, Commack, NY 11725 | 2019-08-20 |
| 1922667716 | Diana Mcnamara | Social Worker | 13 Audrey Lane, Commack, NY 11725 | 2019-06-06 |
| 1821504333 | Amy Koenig | Specialist | 787 Larkfield Rd, Commack, NY 11725 | 2017-12-19 |
| 1437661501 | Commack Chemist Inc | Pharmacy | 6216 Jericho Turnpike, Commack, NY 11725 | 2017-10-30 |
| 1285168880 | Stephanie Arico | Counselor | 14 Silver Pond Cir, Commack, NY 11725 | 2017-04-20 |
| 1235684432 | Ams Primary Medical Care House Calls,pc | Home Health | 6277 Jericho Tpk, Commack, NY 11725 | 2016-08-18 |
| 1376927459 | Min Sun Park | Dentist | All About Smiles Pediatric Dentistry, 5036 Jericho Turnpike Suite #307, Commack, NY 11725 | 2015-07-17 |
| 1467843748 | Joanna Keegan | Pharmacy Technician | 98 Veterans Memorial Highway, Commack, NY 11725 | 2015-02-09 |
| 1275936841 | Jennie Bernstein | Social Worker | 368 Veterans Hwy Ste 2, Commack, NY 11725 | 2014-09-26 |
| 1417362021 | Diana Matira Yildirim | Pediatrics | 646 Commack Road, Commack, NY 11725 | 2014-06-23 |
| Find all providers in zip 11725 | ||||
| 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 |
|---|---|---|---|---|
| 1871146290 | Brittany Marie Imperato | Specialist | 26 Parkview Dr, Commack, NY 11725-3516 | 2019-07-24 |
| 1861963464 | Jenna E Maggio | Specialist | 38 Timber Ridge Dr, Commack, NY 11725-1742 | 2018-12-09 |
| 1447736384 | Alison Rae Wilkins | Specialist | 4 Arden Ln, Commack, NY 11725-1302 | 2018-07-13 |
| 1194223321 | Tonianne Leighton | Specialist | 70 Washington Blvd, Commack, NY 11725-1730 | 2018-01-23 |
| 1821504333 | Amy Koenig | Specialist | 787 Larkfield Rd, Commack, NY 11725 | 2017-12-19 |
| 1750805057 | Melany Flynn | Specialist | 21 Raven Dr, Commack, NY 11725-4707 | 2017-07-28 |
| 1871027797 | Alexandra Drago | Specialist | 77 Tulipwood Dr, Commack, NY 11725-5624 | 2017-04-18 |
| 1326499211 | Kerry Sinkevich | Specialist | 39 Valleywood Rd, Commack, NY 11725-4308 | 2016-06-22 |
| 1881040947 | Christine Valeri | Specialist | 50 Wesleyan Rd, Commack, NY 11725-2519 | 2016-05-09 |
| 1023478799 | Kate Rice | Specialist | 16 Wichard Blvd, Commack, NY 11725-1707 | 2016-02-24 |
| Find all providers in COMMACK | ||||
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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.