FREDRIC DAUM (NPI# 1568446839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568446839 |
| Entity Type | Individual |
| Full Name | FREDRIC DAUM |
| Credential | MD |
| Practice Address |
120 Mineola Blvd Suite 210 Mineola NY 11501-4073 |
| Mailing Address |
222 Station Plz N Suite 611 Mineola NY 11501-3808 |
| Practice Telephone | 5166634600 |
| Practice Fax Number | 5166638297 |
| Mailing Telephone | 5166632532 |
| Mailing Fax Number | 5166632233 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
102580 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00177555 | 05 |
| Street Address |
120 MINEOLA BLVD SUITE 210 |
| City | MINEOLA |
| State | NY |
| Zip Code | 11501-4073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609869734 | Valerie Cucco | Obstetrics & Gynecology | 120 Mineola Blvd, Suite 100, Mineola, NY 11501-4073 | 2005-08-24 |
| 1447892153 | Cassandra Singh | Nurse Practitioner | 120 Mineola Blvd, Mineola, NY 11501-4064 | 2019-10-14 |
| 1750739876 | Jaime Michelle Tramontana | Genetic Counselor, MS | 120 Mineola Blvd, Suite 210, Mineola, NY 11501-4064 | 2016-05-31 |
| 1770944688 | Jessica Hoey | Internal Medicine | 120 Mineola Blvd, Mineola, NY 11501 | 2016-03-19 |
| 1689039505 | Winthrop Faculty Medical Affiliates University Faculty Practice Corpor | Emergency Medicine | 120 Mineola Blvd, Suite 360, Mineola, NY 11501-4064 | 2015-12-18 |
| 1013372135 | Winthrop Faculty Medical Affiliates University Faculty Practice Corpor | Surgery | 120 Mineola Blvd, Suite 300, Mineola, NY 11501-4064 | 2015-12-16 |
| 1639555428 | Anne-marie Wise | Nurse Practitioner | 120 Mineola Blvd, Suite 100, Mineola, NY 11501-4064 | 2015-08-04 |
| 1518342021 | Sherin Philip | Nurse Practitioner | 120 Mineola Blvd, 100, Mineola, NY 11501-4064 | 2015-07-26 |
| 1093199564 | Winthrop Faculty Medical Affiliates University Faculty Practice Corp | Allergy & Immunology | 120 Mineola Blvd, Suite 410, Mineola, NY 11501-4064 | 2015-07-15 |
| 1154702850 | Abigail Weinberg | Genetic Counselor, MS | 120 Mineola Blvd, Suite 210, Mineola, NY 11501-4064 | 2015-06-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500350 | Steve Abraham Simon | Student in an Organized Health Care Education/Training Program | 222 Station Plaza, Suite 509, Mineola, NY 11501 | 2020-05-18 |
| 1407478167 | Frederick Milton Bosoy | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, Ny 11501, Mineola, NY 11501 | 2020-05-15 |
| 1982226130 | Katelyn Anne Fowler | Counselor | [email protected], 410 East Jericho Tpke, Mineola, NY 11501 | 2020-05-11 |
| 1225667819 | New York Dialysis Services, Inc | Clinic/Center | 1 East Jericho Turnpike, Mineola, NY 11501 | 2020-04-06 |
| 1518500032 | Irina Victoria Kushnareva | Social Worker | 126 Saville Rd, Mineola, NY 11501 | 2019-10-28 |
| 1861046336 | Milagros M Matias | Case Manager/Care Coordinator | 39 E. Jericho Turnpike, Mineola, NY 11501 | 2019-08-01 |
| 1154974244 | Bahram Dabiri | Student in an Organized Health Care Education/Training Program | 222 Station Plaza N., Suite 620 Mineola, Mineola, NY 11501 | 2019-07-18 |
| 1972168748 | Nabeel A. Arain | Physician Assistant | 251 1st St., Mineola, NY 11501 | 2019-05-07 |
| 1598328940 | Ramsha Jabbar | Student in an Organized Health Care Education/Training Program | 222 Station Plaza North, Suite 305, Mineola, NY 11501 | 2019-04-20 |
| 1235628850 | Valentyna Erstenyuk | Student in an Organized Health Care Education/Training Program | 222 Station Plaza N, Suite 611, Mineola, NY 11501 | 2018-05-09 |
| Find all providers in zip 11501 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932361961 | Farrah Beth Lazare | Pediatrics | 120 Mineola Blvd, Suite 210, Mineola, NY 11501-4073 | 2008-07-01 |
| 1063421196 | Rolando Capati Guevarra | Pediatrics | 222 Station Plz N, Suite 408, Mineola, NY 11501-3808 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346710977 | Ari J Bergwerk | Pediatrics | Apt #4b 305 Riverside Drive, New York, NY 10025 | 2018-11-27 |
| 1306227525 | Karine Amirikian | Pediatrics | 3415 Bainbridge Ave Fl 7, Bronx, NY 10467 | 2015-06-12 |
| 1407198120 | Elizabeth Anne Nofi Berg | Pediatrics | 622 W 168th St Ph 17, New York, NY 10032-3720 | 2013-03-20 |
| 1316289093 | Anastasia Rigas | Pediatrics | 18 Blueberry Ridge Rd, Setauket, NY 11733-1504 | 2013-03-20 |
| 1366700874 | Dominique Drummond Bailey | Pediatrics | 630 W. 168th Street - Chn 517, Columbia University Medical Center, New York, NY 10032 | 2012-05-03 |
| 1235404559 | Judy Rose Dayan | Pediatrics | 990 E 22nd St, Brooklyn, NY 11210-3610 | 2012-03-20 |
| 1922386994 | Aamer Imdad | Pediatrics | 725 Irving Ave Suite 504, Syracuse, NY 13210 | 2011-07-25 |
| 1982908786 | Eileen Mcvey | Pediatrics | 503 Grasslands Rd Ste 201, Valhalla, NY 10595-1593 | 2011-01-07 |
| 1649404260 | Colleen Ann Nugent | Pediatrics | 239 Bryant Str, Women and Children's Hospital of Buffalo, Buffalo, NY 14222 | 2009-05-11 |
| 1457546582 | Babu S Bangaru | Pediatrics | 9422 59th Ave, Elmhurst, NY 11373-5151 | 2007-09-12 |
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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.