URANTIA MEDICAL PC (NPI# 1679847008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679847008 |
| Entity Type | Organization |
| Organization Name | URANTIA MEDICAL PC |
| Practice Address |
1295 Northern Blvd Suite 20 Manhasset NY 11030-3035 |
| Mailing Address |
1295 Northern Blvd Manhasset NY 11030-3035 |
| Practice Telephone | 5163654040 |
| Mailing Telephone | 5163654040 |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2012-03-23 |
| Authorized Official Name | MODESTO FONTANEZ (PRINCIPAL) |
| Authorized Official Telephone | 5163654040 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | NY | Other Service Providers | |
| Y | 174400000X | Specialist | 1818101 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01583586 | 05 |
| Street Address |
1295 NORTHERN BLVD SUITE 20 |
| City | MANHASSET |
| State | NY |
| Zip Code | 11030-3035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790399608 | Alejandro Matus | Durable Medical Equipment & Medical Supplies | 1295 Northern Blvd, Manhasset, NY 11030-3035 | 2020-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754126 | Diana Fox | Registered Nurse | 330 Community Drive, Manhasset, NY 11030 | 2019-05-02 |
| 1215470257 | Melissa Fackler | Registered Nurse | 1350 Northern Blvd Ste 202, Manhasset, NY 11030 | 2016-11-23 |
| 1821443391 | Sarah Javdan | Family Medicine | 800 Community Dr Ste 206, Manhasset, NY 11030 | 2016-05-03 |
| 1891167458 | Stacie Thaw Lcsw Pllc | Social Worker | 115 Park Ave., Manhasset, NY 11030 | 2015-10-22 |
| 1538547971 | Aarti Kumar | Podiatrist | 535 Plandome Rd # 2, Manhasset, NY 11030 | 2015-05-18 |
| 1073933586 | Rachel Durante | Occupational Therapist | 600 Community Drive, Manhasset, NY 11030 | 2014-04-23 |
| 1831436435 | Anesthesia Care, P.C. | General Practice | 565 Plandome Road, Manhasset, NY 11030 | 2013-01-16 |
| 1821350091 | Sylvia Yoonsun Kim | Pharmacist | 139 Vanderbilt Ave, Manhasset, NY 11030 | 2012-06-13 |
| 1699062588 | Rod Stern | Dentist | 444 Community Dr Ste 201, Manhasset, NY 11030 | 2011-06-30 |
| 1558654798 | Alexandria Pace Kress | Speech-Language Pathologist | 31 Circle Dr, Manhasset, NY 11030 | 2011-05-20 |
| Find all providers in zip 11030 | ||||
| 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 |
|---|---|---|---|---|
| 1972011534 | Michelle Claire Dellaquila | Specialist | 117 Revere Rd, Manhasset, NY 11030-2732 | 2018-01-17 |
| 1598207870 | Jessica Cohen | Specialist | 15 Drake Ln, Manhasset, NY 11030-1229 | 2016-11-17 |
| 1053724237 | Susan Jane Mazer | Specialist | 59 Harrow Ln, Manhasset, NY 11030-3538 | 2014-06-05 |
| 1245667674 | Carin Ann Sanders | Specialist | 1 Bayview Rd, Manhasset, NY 11030-1006 | 2013-09-30 |
| 1518214592 | Sabrina Bellis | Specialist | 12 Pinewood Rd, Manhasset, NY 11030-1512 | 2012-08-09 |
| 1629339502 | Kristen Mitaritonna | Specialist | 347 Mill Spring Rd, Manhasset, NY 11030-3624 | 2012-06-06 |
| 1306115779 | Sharon-marie Rooney | Specialist | 161 Village Rd, Manhasset, NY 11030-3533 | 2011-12-14 |
| 1801124011 | Carlos A Diaz | Specialist | 209 Old Mill Rd, Manhasset, NY 11030-3438 | 2009-11-28 |
| 1881849248 | Lorie R Racanello | Specialist | 28 Rolling Hill Rd, Manhasset, NY 11030-2515 | 2008-11-25 |
| 1710139829 | Progressive Ear, Nose & Throat Assoc., Pllc | Specialist | 333 East Shore Road, #102, Manhasset, NY 11030 | 2008-10-21 |
| Find all providers in MANHASSET | ||||
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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.