MOTT HAVEN MEDICAL OF NEW YORK LLC (NPI# 1457873234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457873234 |
| Entity Type | Organization |
| Organization Name | MOTT HAVEN MEDICAL OF NEW YORK LLC |
| Practice Address |
384 E 149th St Ste 201 Bronx NY 10455-3908 |
| Mailing Address |
304 Wainwright Dr Northbrook IL 60062-1900 |
| Practice Telephone | 7183011100 |
| Practice Fax Number | 2242468042 |
| Mailing Telephone | 8472571244 |
| Mailing Fax Number | 2242468042 |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |
| Authorized Official Name | FLORA KATSNELSON (OWNER) |
| Authorized Official Telephone | 8472571244 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036113246 | 05 |
| Street Address |
384 E 149TH ST STE 201 |
| City | BRONX |
| State | NY |
| Zip Code | 10455-3908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946331 | Nutrished Dietitian Nutrition Solutions, P.C. | Dietitian, Registered | 2825 Third Ave Suite #301, Bronx, NY 10455 | 2020-09-15 |
| 1538641907 | Michelle Flores | Pharmacy Technician | 754 E 151 St, Bronx, NY 10455 | 2018-09-03 |
| 1669973285 | Uhc Adult Day Program & Transportation Services, Inc | Non-emergency Medical Transport (VAN) | 368, East 149th Street Suite 3a, Bronx, NY 10455 | 2018-02-28 |
| 1578061206 | Ursula Ma Stafford | Case Management | 391 East 149 St, Suite 417, Bronx, NY 10455 | 2018-01-29 |
| 1942714506 | Chantal J George | Case Manager/Care Coordinator | 391 East 149th Street, 417, Bronx, NY 10455 | 2017-11-18 |
| 1598295800 | Sonrisa Corp | Pharmacy | 755b East 149th St, Bronx, NY 10455 | 2017-06-19 |
| 1962931378 | Josepjh Appau | Licensed Practical Nurse | 512 Jackson Avenue, Apt 2a, Bronx, NY 10455 | 2017-06-08 |
| 1295187664 | Leticia Robles | Social Worker | 480 Concord Avenue Apt#3j, Bronx, NY 10455 | 2016-07-08 |
| 1811350242 | Jenna Medical Office PC | Family Medicine | 2742 Third Avenue, Bronx, NY 10455 | 2016-04-02 |
| 1841656857 | Heracles Medical PC | Internal Medicine | 2825 Third Ave, Suite 7, Bronx, NY 10455 | 2016-01-06 |
| Find all providers in zip 10455 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528547312 | Norwood Professional Medical Services of New York LLC | Surgery | 3487-89 Jerome Ave, Ste A, Bronx, NY 10468 | 2018-08-13 |
| 1336628130 | Norwood Medical of New York LLC | Surgery | 3487-89 Jerome Ave, Ste B, Bronx, NY 10468 | 2018-08-13 |
| 1124524970 | Fordham Professional Medical Services of New York LLC | Surgery | 11 E Fordham Rd Ste A, Bronx, NY 10468-5406 | 2018-04-02 |
| 1205332905 | Fordham Medical of New York LLC | Surgery | 11 E Fordham Rd Ste B, Bronx, NY 10468-5406 | 2018-04-02 |
| 1366956260 | Foxhurst Professional Medical Services of New York LLC | Surgery | 947 Southern Blvd Ste A, Bronx, NY 10459-3401 | 2017-11-30 |
| 1063926962 | Pelham Pkwy Professional Medical Services of New York LLC | Surgery | 2157 White Plains Rd Ste A, Bronx, NY 10462 | 2017-11-30 |
| 1730547522 | Foxhurst Medical of New York LLC | Surgery | 947 Southern Blvd Ste B, Bronx, NY 10459 | 2016-02-08 |
| 1861649055 | Anoushiravan Amini Hadjibashi | Surgery | 3400 Bainbridge Ave # 4311, Bronx, NY 10467-2404 | 2008-08-19 |
| 1588733232 | Teruo Hirose | Surgery | 5830 Tyndall Ave, Bronx, NY 10471-2108 | 2006-11-07 |
| 1164504320 | Kenneth A Goldstein | Surgery | Eastern Vascular Assoc, 3219 East Tremont Avenue, Bronx, NY 10461 | 2006-10-19 |
| Find all providers in BRONX | ||||
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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.