MS. VADEWATTIE MANGRU (NPI# 1467546317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467546317 |
| Entity Type | Individual |
| Full Name | MS. VADEWATTIE MANGRU |
| Credential | NP |
| Practice Address |
82-68 164th St Jamaica NY 11432-1121 |
| Mailing Address |
79-01 Broadway D1-01 Elmhurst NY 11373-1329 |
| Practice Telephone | 7188833225 |
| Practice Fax Number | 7188836193 |
| Mailing Telephone | 7183341920 |
| Mailing Fax Number | 7183345958 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
F331468 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00246075 | 05 |
| Street Address |
82-68 164TH ST |
| City | JAMAICA |
| State | NY |
| Zip Code | 11432-1121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023114352 | Aliyamma Samuel | Nurse Practitioner | 82-68 164th St, Jamaica, NY 11432-1121 | 2006-09-15 |
| 1770197519 | Jill Modi | Pharmacist | 82-68 164th St, Jamaica, NY 11432-1121 | 2020-08-31 |
| 1992328264 | Anoosh Zafar Gondal | Student in an Organized Health Care Education/Training Program | 82-68 164th St, Jamaica, NY 11432 | 2020-05-21 |
| 1265088983 | Gifty Baffour-addo | Nurse Practitioner | 82-68 164th St, Jamaica, NY 11432-1121 | 2019-08-18 |
| 1790286201 | Grace Kim | Pediatrics | 82-68 164th St, Suite P113, Jamaica, NY 11432-1121 | 2018-02-21 |
| 1053845065 | Tomilade Adepoju | Student in an Organized Health Care Education/Training Program | 82-68 164th St, Jamaica, NY 11432 | 2017-04-17 |
| 1376074328 | Matthew Benjamin Marck | Student in an Organized Health Care Education/Training Program | 82-68 164th St, Jamaica, NY 11432-1121 | 2017-03-22 |
| 1285096081 | Dovid Herskowitz | Physician Assistant | 82-68 164th St, Suite 1b-02, Jamaica, NY 11432 | 2016-03-22 |
| 1326324831 | Zimatu Urenna Chukumerije | Emergency Medicine | 82-68 164th St, Jamaica, NY 11432 | 2011-10-27 |
| 1184933673 | Yvonetta F Morgan | Registered Nurse | 82-68 164th St, Jamaica, NY 11432-1121 | 2010-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396361259 | Banani Road 11 LLC | Pharmacy | 181-04 Hillside Ave, Jamaica, NY 11432 | 2020-06-17 |
| 1023633450 | Staphanie Anang | Licensed Practical Nurse | 30 Wexford Terrace Apt 3 Jj., Jamaica, NY 11432 | 2020-06-11 |
| 1205459476 | Jasmine Kaur Sandhu | Student in an Organized Health Care Education/Training Program | 87-68 164th St, N Building, 7th Floor, Rm N733, Jamaica, NY 11432 | 2020-05-22 |
| 1225650385 | Alli El-ijla | Student in an Organized Health Care Education/Training Program | Queens Hospital Center 82-68 164th Street, Jamaica, NY 11432 | 2020-05-12 |
| 1346869955 | Liane Zwetzich | Student in an Organized Health Care Education/Training Program | Queens Hospital Center, 82-68 164th Street, Jamaica, NY 11432 | 2020-04-14 |
| 1528697141 | Bahtiyar Toz | Student in an Organized Health Care Education/Training Program | 82-68 164th Street Queens Hospital Center, Jamaica, NY 11432 | 2020-04-06 |
| 1366089468 | Alisha Jnobaptiste | Counselor | 87-59 171 St., Jamaica, NY 11432 | 2019-12-08 |
| 1356995054 | Shawnette Natasha Brown | Counselor | 178-02/04 Jamaica Ave, Jamaica, NY 11432 | 2019-07-31 |
| 1518527142 | Magdalene Vidal | Case Manager/Care Coordinator | 177 30 Wexford Terrace, Suite A, Jamaica, NY 11432 | 2019-06-17 |
| 1811550338 | Rong Fan | Student in an Organized Health Care Education/Training Program | 88-68 164th St, Dept of Ob/gyn Rm B265, Jamaica, NY 11432 | 2019-04-19 |
| Find all providers in zip 11432 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073995569 | Carrie Li | Nurse Practitioner | 8268 164th St, Jamaica, NY 11432-1121 | 2015-06-22 |
| 1114017217 | Judy Michel | Nurse Practitioner | 8268 164th St, Jamaica, NY 11432-1121 | 2006-10-13 |
| 1699864645 | Daniella Salnave Bouzi | Nurse Practitioner | 8268 164th St, Jamaica, NY 11432-1121 | 2006-10-11 |
| 1871689430 | Carole Dufour | Nurse Practitioner | 82-68 164th St, Jamaica, NY 11432-1121 | 2006-10-04 |
| 1922105493 | Fay Veloris Thompson | Nurse Practitioner | 82-68 164th St, Jamaica, NY 11432-1121 | 2006-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667169 | Noemi Villanueva Sta Ana | Nurse Practitioner | 1738 Newbridge Rd Unit 1, North Bellmore, NY 11710-1657 | 2020-10-24 |
| 1881292050 | Andrew Hirschhorn | Nurse Practitioner | 1435 Weaver St, Scarsdale, NY 10583-7018 | 2020-10-11 |
| 1154932036 | Brian Lorenzen | Nurse Practitioner | 25 Barker St Apt 513, Mount Kisco, NY 10549-1635 | 2020-08-13 |
| 1457961062 | Rosaleen Christine Galvin | Nurse Practitioner | 415 East 80th St, Apt. 1n, New York, NY 10075 | 2020-08-07 |
| 1477171684 | Rejane Duarte | Nurse Practitioner | 2600 Netherland Ave Ste 104, Bronx, NY 10463-4813 | 2020-07-14 |
| 1962029009 | Sharon Wu | Nurse Practitioner | 2426 W 3rd St, Brooklyn, NY 11223-5930 | 2020-07-05 |
| 1598381535 | Xue Qin Gao | Nurse Practitioner | 71-44 160th St. Unit 1, Flushing, NY 11365-3088 | 2020-06-24 |
| 1619590486 | Jan Jeremiah | Nurse Practitioner | 3839 Flatlands Ave Ste 100, Brooklyn, NY 11234-3535 | 2020-05-27 |
| 1205459534 | Shyan Indera Jagdeo | Nurse Practitioner | 645 W Broadway, Long Beach, NY 11561-2956 | 2020-05-21 |
| 1487276002 | Rosemary Elizabeth Carro | Nurse Practitioner | 21 Adams Farm Rd, Katonah, NY 10536-3166 | 2020-05-18 |
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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.