JESSICA MESIDOR (NPI# 1417402652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417402652 |
| Entity Type | Individual |
| Full Name | JESSICA MESIDOR |
| Credential | PA-C |
| Practice Address |
100 Woods Rd Valhalla NY 10595-1530 |
| Mailing Address |
19 Bradhurst Ave Suite 3100n Hawthorne NY 10532-2140 |
| Practice Telephone | 9143727196 |
| Practice Fax Number | 9149096417 |
| Mailing Telephone | 9149099018 |
| Mailing Fax Number | 9149099028 |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
020023 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NYS LICENSE | 020023 | 01 |
| Street Address |
100 WOODS RD |
| City | VALHALLA |
| State | NY |
| Zip Code | 10595-1530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265436802 | Nagwa S. Saleh | Radiology | 100 Woods Rd, Valhalla, NY 10595-1530 | 2005-06-10 |
| 1639779663 | Trevor Anthony Chen Jr. | Pharmacy Technician | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-10-28 |
| 1316544620 | Hansol Lee | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-10-08 |
| 1205445558 | Rizwan Amin | Student in an Organized Health Care Education/Training Program | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-07-23 |
| 1639788821 | Ailan Zhang | Student in an Organized Health Care Education/Training Program | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-07-23 |
| 1578171302 | Yarden Bornovski | Student in an Organized Health Care Education/Training Program | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-07-17 |
| 1780201517 | Anita Boonyoo | Nurse Practitioner | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-06-27 |
| 1972129807 | Lia C Iacuone | Nurse Anesthetist, Certified Registered | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-06-16 |
| 1578187852 | Miriam Heller | Nurse Anesthetist, Certified Registered | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-06-03 |
| 1710509716 | Jennifer Zappa | Pharmacist | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871126946 | Evan Alexander Formosa | Student in an Organized Health Care Education/Training Program | 40 Sunshine Cottege Road, New York Medical College Student Affairs Suite 122a, Valhalla, NY 10595 | 2020-02-18 |
| 1124673223 | Mozibur Rahman | Student in an Organized Health Care Education/Training Program | C/o Pathology, 100 Woods Rd, Valhalla, NY 10595 | 2019-08-06 |
| 1235650243 | Ana Karla F Arias | Psychologist | 503 Grasslands Roas, Suite 101, Valhalla, NY 10595 | 2017-06-29 |
| 1336682327 | Adriana Josandy Arias | Case Manager/Care Coordinator | 503 Grasslands Rd, Suite 101, Valhalla, NY 10595 | 2016-11-23 |
| 1740632934 | Philippe Hoffmann | Counselor | 1700 Old Orchard, Valhalla, NY 10595 | 2016-07-12 |
| 1396195020 | Elizabeth Hendricks | Social Worker | 1700 Old Orchard St, Valhalla, NY 10595 | 2016-06-14 |
| 1427437771 | Stephany Rodriguez | Case Manager/Care Coordinator | 503 Grasslands Road, Suite 101, Valhala, NY 10595 | 2015-05-20 |
| 1437536182 | Shajiuddin Faraz Mohammed | Psychiatry & Neurology | 100 Woods Road Behavioral Health Center Suite-n314, Westchester Medical Center, Department of Psychiatry, Valhalla, NY 10595 | 2015-05-01 |
| 1841685013 | Barbara Constantine | Physical Therapist | 70 Colubus Ave., Valhalla, NY 10595 | 2015-04-03 |
| 1316330418 | Victor Tseng | Anesthesiology | 100 Woods Rd Rm D-228, Valhalla, NY 10595 | 2015-03-12 |
| Find all providers in zip 10595 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316544620 | Hansol Lee | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2020-10-08 |
| 1437790698 | Courtney Bellissimo | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2019-09-30 |
| 1114573383 | Sarah Meghan Amos | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2019-08-14 |
| 1356997787 | Kayla Christine O'brien | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2019-08-12 |
| 1386296689 | Divya Viswanathan | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2019-07-16 |
| 1215494661 | Sara Graney | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2019-02-21 |
| 1518435122 | Katelyn Marie Smith | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595 | 2018-11-13 |
| 1750803037 | Lauren Hanley | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2017-07-08 |
| 1538417316 | Yvonne M Moran | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2012-08-27 |
| 1497036941 | Maryana Koshyk | Physician Assistant | 100 Woods Rd, Valhalla, NY 10595-1530 | 2011-08-29 |
| Find all providers in VALHALLA | ||||
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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.