DR. WILLIAM JOHN CLOSSON (NPI# 1588001317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588001317 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM JOHN CLOSSON |
| Credential | PH.D. |
| Practice Address |
179 Jayne Ave Patchogue NY 11772-2836 |
| Practice Telephone | 5165272153 |
| Practice Fax Number | 6313374094 |
| Mailing Telephone | 5165272153 |
| Mailing Fax Number | 6313374094 |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
CLOSW1 | NY | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01424097 | 05 |
| Street Address |
179 JAYNE AVE |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772-2836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447224 | Amita Vipul Patel | Nurse Practitioner | Longlsland Community Hospital, 101 Hospital Rd, Patchogue, NY 11772 | 2020-08-13 |
| 1609491968 | Sanjib Dey | Family Medicine | Brookhaven Nephrology Associates, 260 E. Patchogue-yaphank Rd., Patchogue, NY 11772 | 2020-06-12 |
| 1992297204 | Camila Bueno-sanchez | Student in an Organized Health Care Education/Training Program | 676 S Country Rd, East Patchogue, NY 11772 | 2018-06-01 |
| 1184115859 | Premier Endodontics of Patchogue | Dentist | 44 Medford Avenue, Patchogue, NY 11772 | 2018-05-29 |
| 1801386453 | Franklin Ikechukwu Ugbode | Student in an Organized Health Care Education/Training Program | 100 Hospital Road Suite 201, Patchogue, NY 11772 | 2018-05-18 |
| 1508372335 | Stephanie Vanschaick | Counselor | 450 Waverly Ave Ste 11, Patchogue, NY 11772 | 2017-12-15 |
| 1578074498 | Chrystal Lee Curran | Specialist | 1116 Main Road, Aquebogue, NY 11772 | 2017-10-18 |
| 1013457712 | Candyce Fahner | Registered Nurse | 22 Haig Ave, E Patchogue, NY 11772 | 2017-02-28 |
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| Find all providers in zip 11772 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093265472 | Janelle Haylett | Pathology | 121 Rondout Drive, Q, Kingston, NY 12401 | 2016-10-10 |
| 1083075212 | Kenneth Ihenetu | Pathology | 785 Delaware Ave Fl 1, Delmar, NY 12054-9713 | 2016-03-16 |
| 1780050815 | Lars Frederick Westblade | Pathology | Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065-7940 | 2015-08-12 |
| 1962843482 | Yeshpal S Chauhan | Pathology | 140 58th St Ste A, Unit 3l, Brooklyn, NY 11220-2539 | 2013-07-12 |
| 1265781504 | Yan Zhang | Pathology | 601 Elmwood Ave Box 608, Rochester, NY 14642-0001 | 2012-08-31 |
| 1841568524 | Marjorie Bonhomme | Pathology | 522 Alicia Dr, Westbury, NY 11590-1311 | 2011-12-08 |
| 1245408038 | Djamshid Shirazian | Pathology | 4603 Middle Country Rd, 12-3 Suny Incubator, Calverton, NY 11933 | 2008-02-14 |
| 1487822375 | Foroozan Mokhtarian | Pathology | Suny Incubator 4603 Middle Country Road, Suite 12-3, Calverton, NY 11933 | 2008-02-14 |
| 1356948392 | Magda F. Baskharoun-guirguis | Pathology | 6103 Strickland Ave Ste D, Brooklyn, NY 11234-6408 | 2020-10-02 |
| 1619599859 | Bing Su | Pathology | 2821 Wehrle Dr Ste 9, Williamsville, NY 14221-7386 | 2020-05-11 |
| Find all providers with the same taxonomy | ||||
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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.