LIDIA CICCONETTI (NPI# 1629160866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629160866 |
| Entity Type | Individual |
| Full Name | LIDIA CICCONETTI |
| Credential | PA |
| Practice Address |
900 Franklin Ave Valley Stream NY 11580-2145 |
| Practice Telephone | 5162566000 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-11-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
008924 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9103231 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | LICENSE # | PA9103231 | 01 |
| NY | LICENSE | 008924 | 01 |
| FL | 001320600 | 05 |
| Street Address |
900 FRANKLIN AVE |
| City | VALLEY STREAM |
| State | NY |
| Zip Code | 11580-2145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285639591 | Jerald Darvishzadeh | Anesthesiology | 900 Franklin Ave, Anesthesia Department, Valley Stream, NY 11580-2145 | 2005-06-15 |
| 1205442100 | Madeleine Ann Reyes | Surgery | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-09-17 |
| 1376153700 | Mei L Lu | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-07-31 |
| 1508484858 | Virghinya Ridwan | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-07-13 |
| 1588298806 | Melissa Lopez | Nurse Practitioner | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2020-02-25 |
| 1659918316 | Nassau Spine Intraop Monitoring Medical | Specialist/Technologist, Other | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-12-02 |
| 1841841145 | Hannah Elizabeth Mathew | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-09-27 |
| 1972154565 | Karim Mohamed | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-09-25 |
| 1992354427 | Jessy Mathew | Nurse Practitioner | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-09-07 |
| 1073162913 | Nicholas Crozier | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807276 | Jason Diana Lmsw | Clinic/Center | 50 West Hawthorne Ave 2nd Floor, Valley Stream, NY 11580 | 2020-10-09 |
| 1346853033 | R.l. Physical Therapy | Physical Therapist | 1676 Putney Road, Valley Stream, NY 11580 | 2020-08-24 |
| 1427523869 | Jessica Doyle | Social Worker | 5-11 Pflug Pl, Valley Stream, NY 11580 | 2018-10-12 |
| 1013491026 | Syeda Afshan Firdous | Licensed Practical Nurse | 13 Cleaveland St, Valley Stream, NY 11580 | 2018-09-17 |
| 1700377934 | Jisha Merin Mathew | Nurse Practitioner | 1835 Oliver Ave, Apt 4, Valley Stream, NY 11580 | 2018-05-23 |
| 1669970273 | Terrice Bell | Social Worker | 50 W Hawthorne Avenue, Valley Streams, NY 11580 | 2018-01-29 |
| 1659883718 | Rita M. Fowler | Registered Nurse | 33 West Hawthorne Ave. Suite 31, New York Health Care, Valley Stream, NY 11580 | 2017-10-30 |
| 1881104768 | Sharon Stephenson | Peer Specialist | 51 Foster Avenue, North Valley Stream, Valley Stream, NY 11580 | 2017-10-05 |
| 1356850200 | Barry Henderson | Case Manager/Care Coordinator | 23 Marlow Road, Valley Stream, NY 11580 | 2017-09-22 |
| 1922526565 | Aneta Kaczmarski | Physical Therapy Assistant | 299 North Corona Ave, Valley Stream, NY 11580 | 2017-09-05 |
| Find all providers in zip 11580 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922625870 | Harrison Joseph Lave | Physician Assistant | 133 E Merrick Rd, Valley Stream, NY 11580-5900 | 2020-06-26 |
| 1073175782 | Erin Rose Mcnamara | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2019-07-02 |
| 1891270328 | Kelly Marina Darnell | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2018-10-01 |
| 1295736353 | James Michael Behan Sr. | Physician Assistant | 900 Franklin Ave, Valley Stream, NY 11580-2145 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434727 | Julia Loren Bartsch | Physician Assistant | 11791 Genesee St, Alden, NY 14004-9713 | 2020-10-16 |
| 1295347078 | Alana Janine Miller | Physician Assistant | 1060 5th Ave # 1b, New York, NY 10128-0104 | 2020-08-21 |
| 1336768647 | Abul Sarker | Physician Assistant | 2 Sagamore Ave, Suffern, NY 10901-7412 | 2020-04-16 |
| 1689200412 | Margaret Ann Sullivan | Physician Assistant | 7011 108th St Apt 4l, Forest Hills, NY 11375-4407 | 2020-03-12 |
| 1376177527 | Anabell Marina Lopez Plaza | Physician Assistant | 12 Berrywood Ct, Bay Shore, NY 11706-2058 | 2020-02-26 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1831736602 | Ll Physician Assistant PC | Physician Assistant | 2279 Coney Island Ave Fl 2, Brooklyn, NY 11223-3337 | 2019-11-29 |
| 1992348775 | Nafiur Rahman Chowdhury | Physician Assistant | 8268 164th St Rm A3-65, Jamaica, NY 11432-1121 | 2019-10-23 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1578114377 | Matthew Newmark Eisenstein | Physician Assistant | 3260 43rd St Apt 2r, Astoria, NY 11103-2745 | 2019-09-23 |
| Find all providers with the same taxonomy | ||||
| City | VALLEY STREAM |
| Zip Code | 11580 |
Please comment or provide details below to improve the information on LIDIA CICCONETTI.
| 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.