SUSAN REBECCA MITCHELL (NPI# 1508281866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508281866 |
| Entity Type | Individual |
| Full Name | SUSAN REBECCA MITCHELL |
| Credential | P.A. |
| Practice Address |
79 Grand Ave Massapequa NY 11758 |
| Mailing Address |
79 Grand Ave Massapequa NY 11758-4905 |
| Practice Telephone | 5167983376 |
| Mailing Telephone | 5167983376 |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2016-03-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0173431 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003378027 | Susan Jane Mitchell | Massage Therapist | 120 W State St Ste 5, Ithaca, NY 14850-5441 | 2019-04-01 |
| 1710445358 | Susan Mitchell | Dietitian, Registered | 1690 Walnut Ave, Winter Park, FL 32789-2036 | 2019-03-02 |
| 1588175160 | Susan Mitchell | Pedorthist | 400 E Red Bridge Rd Ste 305, Kansas City, MO 64131-4031 | 2017-10-23 |
| 1336513837 | Susan Mitchell | Speech-Language Pathologist | 2293 S Harwood Ave, Upper Darby, PA 19082-5405 | 2015-11-20 |
| 1912385360 | Susan Mitchell | Behavioral Analyst | 117 Park Rd, Ambler, PA 19002-1124 | 2015-05-18 |
| 1255649521 | Susan Annette Mitchell | Counselor | 24500 Center Ridge Rd Bldg 4, Suite 100, Westlake, OH 44145-5601 | 2010-09-20 |
| 1447402615 | Susan Lynn Mitchell | Occupational Therapist | 74 Orchard Lake Dr, Monroe, NY 10950-6507 | 2008-10-18 |
| 1235325424 | Susan Mitchell | Physical Therapist | 1783 Forest Dr # 307, Annapolis, MD 21401-4229 | 2007-09-20 |
| 1932221116 | Susan Elizabeth Mitchell | Specialist | 112 Alder Ave, Unit 10, Snohomish, WA 98290-3079 | 2007-04-06 |
| 1225047673 | Susan Diane Mitchell | Occupational Therapist | 8032 Summa Ave, Suite A, Baton Rouge, LA 70809-3478 | 2006-08-05 |
| Street Address |
79 GRAND AVE |
| City | MASSAPEQUA |
| State | NY |
| Zip Code | 11758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457435224 | Diane B. Lucks | Nurse Practitioner | 79 Grand Ave, Massapequa, NY 11758-4905 | 2006-10-25 |
| 1144431628 | Elena T Sanchez | Marriage & Family Therapist | 79 Grand Ave, Massapequa, NY 11758-4905 | 2007-05-25 |
| 1851459820 | Stacy Lynn Entin | Obstetrics & Gynecology | 79 Grand Ave, Massapequa, NY 11758 | 2006-12-04 |
| 1366528127 | Irwin Goldstein | Obstetrics & Gynecology | 79 Grand Ave, Massapequa, NY 11758-4905 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811535339 | Jamie Leigh Disilvio | Licensed Practical Nurse | 24 Amity Pl., Massapequa, NY 11758 | 2019-12-16 |
| 1548787955 | June H Friedman | Social Worker | 78 North Pine Street, North Massapequa, NY 11758 | 2017-08-25 |
| 1376078568 | Caitlin Bree Kennedy | Acupuncturist | 507 Hicksville Road, Massapequa, NY 11758 | 2017-04-25 |
| 1932645561 | Maria Amato | Specialist | 277 Division Ave, Massapequa, NY 11758 | 2017-01-06 |
| 1164877270 | Marylou Lawson | Early Intervention Provider Agency | 87 N Pine Street, N Massapequa, NY 11758 | 2016-04-26 |
| 1417314196 | Tender Heart Senior Care Corp | In Home Supportive Care | 24 Peconic Dr, Massapequa, NY 11758 | 2016-01-26 |
| 1316328420 | Theresa Mackey | Behavioral Analyst | 19 Oxford Avenue, N. Massapequa, NY 11758 | 2015-06-15 |
| 1932596590 | Bianca Ferrantelli | Specialist | 13 Alhabra Rd, Apt 5, Massapequa, NY 11758 | 2015-04-22 |
| 1245625797 | Medwell Medical PC | Pain Medicine | 1065a North Broadway, Massapequa, NY 11758 | 2015-04-01 |
| 1053703926 | Joseph Sgaglione | Physical Therapist | 503 Wright Drive, Massapequa, NY 11758 | 2015-03-02 |
| Find all providers in zip 11758 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083049480 | Jacqueline Marie Napolitano | Physician Assistant | 100 Veterans Blvd Ste 1, Massapequa, NY 11758-4945 | 2013-09-05 |
| 1689914350 | Jennifer Lynn Heimbauer | Physician Assistant | 156 Dartmouth Rd, Massapequa, NY 11758-8124 | 2013-02-18 |
| 1427264472 | Erin M Flynn | Physician Assistant | 4 Dorothy Gate, Massapequa, NY 11758-3521 | 2007-05-15 |
| 1558704775 | John P Kelly | Physician Assistant | 515 Broadway, Massapequa, NY 11758-5005 | 2013-04-08 |
| 1649407495 | Edward Brucia | Physician Assistant | 660 Broadway, Massapequa, NY 11758-2391 | 2009-06-19 |
| 1609945617 | Marietta Busa | Physician Assistant | 727 Broadway, Massapequa, NY 11758 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1477169654 | Kristen Ariel O'connell | Physician Assistant | 85 John St Apt 7a, New York, NY 10038-2844 | 2020-09-22 |
| 1699381616 | David Nmn Kao | Physician Assistant | 737 Pleasant Avenue, Westbury, NY 11590-6407 | 2020-09-16 |
| 1043824816 | Elizabeth Keane | Physician Assistant | 25 Hollis Dr, Sound Beach, NY 11789-1629 | 2020-08-31 |
| 1497364111 | Tianna Stephens | Physician Assistant | 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 | 2020-07-28 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1114547791 | Michele Hein | Physician Assistant | 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
| City | MASSAPEQUA |
| Zip Code | 11758 |
Please comment or provide details below to improve the information on SUSAN REBECCA MITCHELL.
| 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.