DESTA ANTHONY MOBILE NP ADULT HEALTH, PLLC (NPI# 1679188494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679188494 |
| Entity Type | Organization |
| Organization Name | DESTA ANTHONY MOBILE NP ADULT HEALTH, PLLC |
| Practice Address |
8241 Penstock Way Manlius NY 13104-9401 |
| Practice Telephone | 3154133848 |
| Practice Fax Number | 3156924292 |
| Mailing Telephone | 3154133848 |
| Mailing Fax Number | 3156924292 |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |
| Authorized Official Name | DESAT ANTHONY (MEMBER) |
| Authorized Official Telephone | 3155591965 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | DESTA ANTHONY MOBILE NP ADULT HEALTH, PLLC | 8241 Penstock Way, Manlius, Ny 13104 |
| Street Address |
8241 PENSTOCK WAY |
| City | MANLIUS |
| State | NY |
| Zip Code | 13104-9401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790334423 | Cindy Gleason | Technician | 8450 Number 2 Rd East, Manlius, NY 13104 | 2019-09-05 |
| 1275009995 | Tristan Karel Martin | Marriage & Family Therapist | 4500 Pewter Lane, 8&9, Manlius, NY 13104 | 2018-10-20 |
| 1184141715 | Walgreen Co | Pharmacy | 315 Fayette St Ste 3, Manlius, NY 13104 | 2017-08-24 |
| 1518233386 | Edward Theodore Schroeder | Internal Medicine | 8345 Vassar Drive, Manlius, NY 13104 | 2012-03-27 |
| 1790052017 | Megan Lynn Perioli | Counselor | 8219 Market Pl Bldg 10, Manlius, NY 13104 | 2011-12-01 |
| 1194979088 | Erin Elizabeth Kolceski | Speech-Language Pathologist | 8141 Old Sunridge Dr, Manlius, NY 13104 | 2008-11-05 |
| 1700037314 | Peter H Emery Jr. | Pharmacist | 3215 Pompey Center Road, Manlius, NY 13104 | 2008-10-02 |
| 1093987216 | Jason David Henderson | Dentist | 8179 Cazenovia Rd., Manlius, NY 13104 | 2008-03-27 |
| 1154517019 | Cynthia E Cavanaugh | Registered Nurse | 2968 Gulf Rd, Manlius, NY 13104 | 2007-09-24 |
| 1487853537 | Harold Jason Rodman | Dentist | 28 Lincklaen St, Cazenovia, NY 13104 | 2007-07-17 |
| Find all providers in zip 13104 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033325253 | Geraldine Mary Dicosimo | Nurse Practitioner | 8112 Cazenovia Road, Seven Pines Office Bldg. One, Suite 3, Manlius, NY 13104 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427871 | Tammie Kae Copp | Nurse Practitioner | 8266 Casson Rd, Lindley, NY 14858-9697 | 2020-11-08 |
| 1770184673 | Annette Virosami | Nurse Practitioner | 890 Trinity Ave Apt 8d, Bronx, NY 10456-7419 | 2020-11-06 |
| 1972104958 | Jonathan Dillera Nietes | Nurse Practitioner | 4411 Macnish St Apt 1g, Elmhurst, NY 11373-3609 | 2020-11-05 |
| 1407457088 | Sanjana Kumari | Nurse Practitioner | 62 Albertson Pl, Mineola, NY 11501-4601 | 2020-11-02 |
| 1780284927 | Hannah Catan | Nurse Practitioner | 473 W 158th St Apt 10, New York, NY 10032-5361 | 2020-10-27 |
| 1700486248 | Amandeep Kaur | Nurse Practitioner | 7638 270th St, New Hyde Park, NY 11040-1418 | 2020-10-26 |
| 1861091324 | Stacey M Jantsch | Nurse Practitioner | 8237 Cicero Mills Rd, Cicero, NY 13039-8344 | 2020-10-25 |
| 1871192468 | Adult Health Np House Calls, PC | Nurse Practitioner | 7954 Transit Rd # 134, Williamsville, NY 14221-4117 | 2020-10-23 |
| 1104425891 | Tze-hsuan Chao | Nurse Practitioner | 3916 Prince St Ste 257, Flushing, NY 11354-5367 | 2020-10-22 |
| 1992304968 | Nicholas Robinson | Nurse Practitioner | 295 Essjay, Williamsville, NY 14221 | 2020-10-21 |
| 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.