MSAN MEDICAL CARE PC (NPI# 1578065249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578065249 |
| Entity Type | Organization |
| Organization Name | MSAN MEDICAL CARE PC |
| Practice Address |
6861 Fresh Pond Rd Ridgewood NY 11385-5263 |
| Practice Telephone | 7185763354 |
| Practice Fax Number | 7155763505 |
| Mailing Telephone | 7185763354 |
| Mailing Fax Number | 7155763505 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MYAT SAN (PRESIDENT) |
| Authorized Official Telephone | 7185763354 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 231830 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NATIONAL PROVIDER IDENTIFICATION | 1134284581 | 01 |
| Street Address |
6861 FRESH POND RD |
| City | RIDGEWOOD |
| State | NY |
| Zip Code | 11385-5263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326650425 | Nicole Jablonska | Speech-Language Pathologist | 60-24 Grove Street, Ridgewood, NY 11385 | 2020-08-19 |
| 1295393296 | Ila Debra Christmas | Clinic/Center | 67-29 Myrtle Avenue, Glendale, NY 11385 | 2019-06-04 |
| 1164929584 | Carmen E. Vidal | Case Manager/Care Coordinator | 61-06 Metropolitan Ave., Ridgewood, NY 11385 | 2018-04-11 |
| 1467955385 | Avchemists LLC | Pharmacy | 68-28 Myrtle Ave, Glendale, NY 11385 | 2018-03-16 |
| 1235639667 | Yu-jen Hwang | Physical Therapist | 55-05 Myrtle Avenue, 2nd Floor, Ridgewood, NY 11385 | 2018-02-12 |
| 1477069185 | Selena Delgado | Behavior Technician | 64-07 Cooper Avenue, Glendale, NY 11385 | 2017-12-18 |
| 1851806913 | Myrtle Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 7933 Myrtle Ave, Flushing, NY 11385 | 2017-12-11 |
| 1104345727 | Suzanne Eng | Counselor | 1080 Wykoff Ave., Suite D4, Ridgewood, NY 11385 | 2017-09-14 |
| 1588183339 | Geri P Services Inc. | Early Intervention Provider Agency | 5938 Gates Ave, Ridgewood, NY 11385 | 2017-09-13 |
| 1922523935 | Kristen Michele Spang | Speech-Language Pathologist | 79-56 77th Road, Glendale, NY 11385 | 2017-08-10 |
| Find all providers in zip 11385 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326692096 | Deidre Ippolito | Specialist | 1864 Putnam Ave Apt 1r, Ridgewood, NY 11385-4314 | 2019-07-30 |
| 1497222079 | Karen Villacres | Specialist | 506 Grandview Ave Apt 2r, Ridgewood, NY 11385-1996 | 2018-10-31 |
| 1144713306 | Lilibeth Acosta | Specialist | 1627 Cornelia St, Ridgewood, NY 11385-4711 | 2018-06-12 |
| 1851807168 | Ailee Wiscovitch | Specialist | 1820 Cornelia St, Ridgewood, NY 11385-4900 | 2017-12-21 |
| 1386167005 | Kristen Naletilic | Specialist | 1835 Summerfield Street, Ridgewood, NY 11385 | 2017-07-25 |
| 1235672296 | American Healthcare Partners | Specialist | 38 E Ridgewood Ave # 200, Ridgewood, NJ 07450-3808 | 2016-11-23 |
| 1841743887 | Learning Steps Inc. | Specialist | 58-25 69 Ave, Ridgewood, NY 11385 | 2016-07-26 |
| 1639538598 | Yllka Tupi | Specialist | 2055 Gates Ave Apt 2l, Ridgewood, NY 11385-3030 | 2016-02-19 |
| 1609257732 | Robert Foerster | Specialist | 6135 Madison St, Apt 3l, Ridgewood, NY 11385-4038 | 2015-06-15 |
| 1215334255 | Nadia Lia Rivera-dejesus | Specialist | 1823 Madison St, 10, Ridgewood, NY 11385-3750 | 2014-11-19 |
| Find all providers in RIDGEWOOD | ||||
Please comment or provide details below to improve the information on MSAN MEDICAL CARE PC.
| 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.