DR. STACEY A CACCIOLA (NPI# 1407807936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407807936 |
| Entity Type | Individual |
| Full Name | DR. STACEY A CACCIOLA |
| Credential | D.O. |
| Practice Address |
94-98 Manhattan Avenue Brooklyn NY 11206-2505 |
| Mailing Address |
60 Madison Ave Fl 5 New York NY 10010-1600 |
| Practice Telephone | 7183880390 |
| Practice Fax Number | 7184865741 |
| Mailing Telephone | 2125452439 |
| Mailing Fax Number | 6463120481 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-05-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 229060 | NY | Allopathic & Osteopathic Physicians |
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
229060 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03040613 | 05 |
| Street Address |
94-98 MANHATTAN AVENUE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11206-2505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720630544 | Jennifer Rodriguez | Social Worker | 94-98 Manhattan Avenue, Brooklyn, NY 11206-2505 | 2019-07-11 |
| 1982109047 | Aleksandra Sevruk | Social Worker | 94-98 Manhattan Avenue, Brooklyn, NY 11206 | 2018-03-29 |
| 1477065100 | Anna Cummings | Social Worker | 94-98 Manhattan Avenue, Brooklyn, NY 11206 | 2017-11-03 |
| 1780042606 | Colette Russen | Nurse Practitioner | 94-98 Manhattan Avenue, Brooklyn, NY 11206 | 2016-02-05 |
| 1992162184 | Grace O'shaughnessy | Social Worker | 94-98 Manhattan Avenue, Brooklyn, NY 11206-2505 | 2016-01-20 |
| 1306202254 | Erica Dobbins | Social Worker | 94-98 Manhattan Avenue, Brooklyn, NY 11206-2505 | 2016-01-07 |
| 1073984373 | Emily Weitberg | Dentist | 94-98 Manhattan Avenue, Brooklyn, NY 11206 | 2015-10-13 |
| 1164813473 | Jenny Mintz | Social Worker | 94-98 Manhattan Avenue, Brooklyn, NY 11206 | 2015-02-09 |
| 1336538750 | Danny Gomez | Social Worker | 94-98 Manhattan Avenue, Brooklyn, NY 11206 | 2015-01-22 |
| 1104198571 | Casey L Ferber | Social Worker | 94-98 Manhattan Avenue, Brooklyn, NY 11206-2505 | 2012-02-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255957684 | Armyda Montoya Novoa | Student in an Organized Health Care Education/Training Program | Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206 | 2020-06-22 |
| 1528684107 | Elizabeth Nana Ama Sarporma Osei-kuffuor | Student in an Organized Health Care Education/Training Program | 760 Broadway Woodhull Hospital, Pediatrics Administration 6b23, Brooklyn, NY 11206 | 2020-06-19 |
| 1356965057 | Ishan Poudel | Student in an Organized Health Care Education/Training Program | 760 Broadway, Woodhull Medical and Mental Health Center, Gme - Room 10a216, Brooklyn, NY 11206 | 2020-05-29 |
| 1538721303 | Osarodion Osa Igbinomwanhia | Student in an Organized Health Care Education/Training Program | Woodhull Address 760 Broadway, Department of Pediatrics Room 6b23, New York, NY 11206 | 2019-07-02 |
| 1043872955 | Olajide A Sowemimo | Student in an Organized Health Care Education/Training Program | Dept of Pediatrics, Woodhull Hospital, Room 6b23, 760 Broadway, New York, NY 11206 | 2019-07-01 |
| 1184284895 | Jacqueline So | Student in an Organized Health Care Education/Training Program | 760 Broadway, Room 2c319, Brooklyn, NY 11206 | 2019-06-14 |
| 1326607722 | Nicole Chamak | Speech-Language Pathologist | Ps 141k@380, 370 Marcy Ave - Speech Dept, Brooklyn, NY 11206 | 2019-06-10 |
| 1831660356 | Sheena Erica Purcell | Registered Nurse | White Glove Community Care, Inc., 89 Barlett St, 2nd Floor, Brooklyn, NY 11206 | 2018-12-10 |
| 1922578145 | Robert A Rodriguez | Social Worker | 630 Fushing Ave, Brooklyn, NY 11206 | 2018-11-30 |
| 1346724085 | Evelyn Wreh Larbie | Licensed Practical Nurse | White Glove Community Care, 89 Bartlett Street, Brooklyn, NY 11206 | 2018-09-19 |
| Find all providers in zip 11206 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093238339 | Maria Pygerou-kofinas | Pediatrics | 506 Sixth Street Kp4, Brooklyn, NY 11215 | 2017-07-19 |
| 1063893089 | Namirembe Joan Kazibwe | Pediatrics | 539, 85th Street, Apt 3f, Brooklyn, NY 11209 | 2015-06-16 |
| 1114339322 | Michelle Quan | Pediatrics | 388 Bridge St, Apt 11b, Brooklyn, NY 11201-5210 | 2014-05-21 |
| 1952728883 | Thomas Hays | Pediatrics | 41 Hausman St, Brooklyn, NY 11222 | 2014-03-28 |
| 1992885057 | Ali Nadroo | Pediatrics | 236 7th Ave, Brooklyn, NY 11215-3415 | 2006-10-16 |
| 1265523427 | Gratias Tom Mundakel | Pediatrics | 451 Clarkson Ave, C4128, Kings County Hospital Center, Brooklyn, NY 10301 | 2006-09-27 |
| 1194789388 | Asma Asif Ahmad | Pediatrics | 461 Clarkson Ave, Kings County Medical Center, Brooklyn, NY 11203 | 2006-04-14 |
| 1528063377 | John Casey | Pediatrics | 760 Broadway, Woodhull Medical & Mental Health Center, Department of Pediatrics, Brooklyn, NY 11206 | 2005-06-17 |
| 1427445949 | Anna Zylak | Pediatrics | 121 Dekalb Ave, Dept of Pediatrics, The Brooklyn Hospital Center, Brooklyn, NY 11201 | 2015-04-22 |
| 1275960742 | Chris Papazafiratou | Pediatrics | 2601 Ocean Parkway, Brooklyn, NY 11235 | 2013-09-30 |
| 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.