DR. CAROLE LYSAGHT MOODHE (NPI# 1659440170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659440170 |
| Entity Type | Individual |
| Full Name | DR. CAROLE LYSAGHT MOODHE |
| Credential | M.D. |
| Practice Address |
2 Pro Health Plz New Hyde Park NY 11042-1111 |
| Practice Telephone | 5165066885 |
| Practice Fax Number | 5166086824 |
| Mailing Telephone | 5165066885 |
| Mailing Fax Number | 5166086824 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2009-10-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
181854 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00738981 | 05 | |
| NY | EMPIRE MEDICARE | 62K521 | 01 |
| NY | OXFORD MEDICARE | AP603 | 01 |
| NY | 01437714 | 05 | |
| NY | EMPIRE BCBS MEDICARE | 260AD1 | 01 |
| NY | GHI MEDICARE | 06399 | 01 |
| Street Address |
2 PRO HEALTH PLZ |
| City | NEW HYDE PARK |
| State | NY |
| Zip Code | 11042-1111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205831443 | Martin Greenfield | Internal Medicine | 2 Pro Health Plz, New Hyde Park, NY 11042-1111 | 2005-06-15 |
| 1164761656 | Pauline Mizrachi | Internal Medicine | 2 Pro Health Plz, New Hyde Park, NY 11042-1111 | 2013-02-04 |
| 1164716510 | Bijan Zisman | Internal Medicine | 2 Pro Health Plz, New Hyde Park, NY 11042-1111 | 2011-06-02 |
| 1750674230 | Pegah Yousefzadeh | Internal Medicine | 2 Pro Health Plz, Suite 201, New Hyde Park, NY 11042-1111 | 2011-05-17 |
| 1023245008 | Jeffrey David Karwoski | Internal Medicine | 2 Pro Health Plz, New Hyde Park, NY 11042-1111 | 2009-06-16 |
| 1669632196 | Rachel Pessah Pollack | Internal Medicine | 2 Pro Health Plz, Prohealth Care Associates, New Hyde Park, NY 11042-1111 | 2008-06-09 |
| 1548453426 | Agnes Shuh-ming Chen-stiebel | Obstetrics & Gynecology | 2 Pro Health Plz, 2nd Floor, New Hyde Park, NY 11042-1111 | 2007-08-23 |
| 1902006398 | Dihan Carrol Heron | Internal Medicine | 2 Pro Health Plz, New Hyde Park, NY 11042-1111 | 2007-07-23 |
| 1013110840 | Jasdeep Sandhu | Physician Assistant | 2 Pro Health Plz, New Hyde Park, NY 11042-1111 | 2007-06-08 |
| 1821193848 | Robert Mitchell Peters | Legal Medicine | 2 Pro Health Plz, New Hyde Park, NY 11042-1111 | 2006-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871260 | Advanced Cardiovascular Diagnostics, Pllc | Internal Medicine | 410 Lakeville Road Suite 209, New Hyde Park, NY 11042 | 2020-11-02 |
| 1568093771 | Global Slp Ot Pt & Psychological Services, Pllc | Physical Therapist | 1979 Marcus Avenue - Suite 204, Attn: Jon Polish, Lake Success, NY 11042 | 2020-01-28 |
| 1730745761 | Miriam Korbman | Psychologist | 2001 Marcus Ave Suite E128, Lake Success, NY 11042 | 2019-05-15 |
| 1306402409 | Swachi Jain | Student in an Organized Health Care Education/Training Program | Northwell Health Pathology, 6 - Ohio Drive, Suite 202, Lake Success, NY 11042 | 2019-05-14 |
| 1215407432 | Samara Carly Badash | Physical Therapist | Brookville Center for Children's Services, 1983 Marcus Avenue, Suite E100, New Hyde Park, NY 11042 | 2018-11-30 |
| 1720578578 | Nidhi Kataria | Student in an Organized Health Care Education/Training Program | Department of Pathology and Laboratory Medicine, Northw, 6 Ohio Drive, Suite 202, Lake Success, NY 11042 | 2018-05-17 |
| 1558870162 | Rosemary Elizabeth Fine | Nurse Practitioner | 1999 Marcus Ave Ste 306, New Hyde Park, NY 11042 | 2017-09-26 |
| 1255861159 | Nicole Renee Cohen | Speech-Language Pathologist | 1893 Marcus Ave, C118, New Hyde Park, NY 11042 | 2017-06-14 |
| 1366807943 | Molly Rubinoff | Nurse Practitioner | 1215 One Hollow Lane, #301, New Hyde Park, NY 11042 | 2015-12-23 |
| 1255701959 | Prohealth Dental Pllc | Dentist | 1 Pro Health Plz, Suite 115, New Hyde Park, NY 11042 | 2015-10-07 |
| Find all providers in zip 11042 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124503669 | Boahen Owusu Kwakye | Family Medicine | 3000 Marcus Ave Ste 2w15, New Hyde Park, NY 11042-1005 | 2018-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220677 | Ellen Mcstravick | Family Medicine | 5530 Sheridan Dr Ste 2, Williamsville, NY 14221-3730 | 2020-09-18 |
| 1598384489 | Jimmy Gelin | Family Medicine | 18639 140th Ave, Springfield Gardens, NY 11413-2617 | 2020-04-11 |
| 1871145011 | Prince Aboagye Dankwah | Family Medicine | 157 Barnes Rd, Washingtonville, NY 10992-1931 | 2019-07-09 |
| 1194206441 | Madison Physician Practice PC | Family Medicine | 983 Park Ave # 1d, New York, NY 10028-0808 | 2018-08-24 |
| 1245717115 | Darlean James | Family Medicine | 183 Park St Ste 5678, Malone, NY 12953 | 2018-07-24 |
| 1609380617 | Donna Yu | Family Medicine | 6402 8th Ave Ste 301, Brooklyn, NY 11220-4720 | 2017-11-29 |
| 1720591688 | Jane S Ferraina | Family Medicine | 259 Boughton Hill Rd, Honeoye Falls, NY 14472-9706 | 2017-11-14 |
| 1245750918 | Long Island Nurse Practitioners | Family Medicine | 97 Ronni Dr, East Meadow, NY 11554-1330 | 2017-06-23 |
| 1548700925 | Special Medical PC | Family Medicine | 699 B Stanley Avenue, Brooklyn, NY 11207 | 2017-03-03 |
| 1043762404 | Ji Medical Group PC | Family Medicine | 3825 Parsons Blvd, Ste 1g, Flushing, NY 11354-5837 | 2016-11-01 |
| Find all providers with the same taxonomy | ||||
| City | NEW HYDE PARK |
| Zip Code | 11042 |
Please comment or provide details below to improve the information on DR. CAROLE LYSAGHT MOODHE.
| 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.