ST. JOSEPH'S IMAGING (NPI# 1457361529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457361529 |
| Entity Type | Organization |
| Organization Name | ST. JOSEPH'S IMAGING |
| Practice Address |
4109 Medical Center Dr Fayetteville NY 13066-6600 |
| Practice Telephone | 3153297555 |
| Practice Fax Number | 3153297559 |
| Mailing Telephone | 3153297555 |
| Mailing Fax Number | 3153297559 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2011-10-03 |
| Authorized Official Name | MS. ANN M ROMAN (INTERVENTIONAL RADIOLOGY) |
| Authorized Official Telephone | 3153297555 |
| Authorized Official Credential | MS APRN BC ANP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
302135 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ST. JOSEPH'S IMAGING ASSOCIATES, PLLC | Hiscock & Barclay LLP, 1 Park Place 300 S State St, Syracuse, Ny 13202 |
| Street Address |
4109 MEDICAL CENTER DR |
| City | FAYETTEVILLE |
| State | NY |
| Zip Code | 13066-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
| Find all providers in zip 13066 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902456593 | Ana Roselia Santos Burks | Nurse Practitioner | 2041 Valleygate Dr Ste 101, Fayetteville, NC 28304-3746 | 2019-09-16 |
| 1801364377 | Ann Marie Alicia Burke | Nurse Practitioner | 2717 Preston Woods Ln Apt 2, Fayetteville, NC 28304-3627 | 2018-11-02 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1295185213 | Nyaradzo Ogunwo | Nurse Practitioner | 1315 Aztek Pl, Fayetteville, NC 28314-6112 | 2016-06-21 |
| 1598126179 | Temica Bohannon Niblack | Nurse Practitioner | 100 Halcyon Ct, Fayetteville, GA 30214-5375 | 2016-03-10 |
| 1043656093 | Sharon Foster-geeter | Nurse Practitioner | 3613 Cape Center Dr, Fayetteville, NC 28304-4457 | 2013-05-17 |
| 1013225697 | Adrian Nicole Lennon | Nurse Practitioner | 2018 Fort Bragg Rd Ste 110a, Fayetteville, NC 28303-7038 | 2010-09-17 |
| 1821008194 | Toni R. Guzi | Nurse Practitioner | 1260 Highway 54 West, Suite 101, Fayette Care Clinic, Fayetteville, GA 30214 | 2006-08-09 |
| 1588630883 | Nancy Zlomek | Nurse Practitioner | 4212 Medical Center Dr, Eastside Internal Medicine, Fayetteville, NY 13066-6642 | 2006-02-27 |
| 1477197812 | Kimberly G Luckman | Nurse Practitioner | 115 Sumner Rd, Fayetteville, GA 30214-4758 | 2019-10-29 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 13066 |
Please comment or provide details below to improve the information on ST. JOSEPH'S IMAGING.
| 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.