MS. STEPHANIE NICOLE LIVERMORE (NPI# 1710288741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710288741 |
| Entity Type | Individual |
| Full Name | MS. STEPHANIE NICOLE LIVERMORE |
| Credential | PA-C |
| Practice Address |
4900 Broad Rd Syracuse NY 13215 |
| Mailing Address |
750 E Adams St Syracuse NY 13210-2342 |
| Practice Telephone | 3154925011 |
| Practice Fax Number | 3154925320 |
| Mailing Telephone | 3154645540 |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2019-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 014286 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 750 E Adams St, Syracuse, NY 132102342 | 3154645540 |
| Street Address |
4900 BROAD RD |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336143221 | David C Canfield | Anesthesiology | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2005-06-08 |
| 1205474335 | Meaghan Porter | Physical Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-12-19 |
| 1982262655 | Ryan Christopher Staib | Nurse Anesthetist, Certified Registered | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-05-29 |
| 1164989505 | Jessica Detor | Social Worker | 4900 Broad Rd, Physician Office Building North 3n, Syracuse, NY 13215-2265 | 2019-02-21 |
| 1316402415 | Oleksandr Kaplun | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-02-04 |
| 1003390204 | Ianna Javier Garcia | Occupational Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-24 |
| 1194207241 | Rebekah Schu | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-05 |
| 1669990065 | Katrina E Garrigan | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-06 |
| 1336667948 | Kristy Mcgough | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-04 |
| 1285158402 | Nicholas David Treinin | Pharmacist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367785 | Jeffrey Alan Gaulrapp | Registered Nurse | Upstate University Hospital Community General Campus, 4900 Broad Road, Syracuse, NY 13215 | 2020-05-08 |
| 1134752454 | Crystal Elizabeth Hoban | Marriage & Family Therapist | 4922 W. Seneca Turnpike, Syracuse, NY 13215 | 2020-02-14 |
| 1083004907 | Roger G Levine Md | Psychiatric Residential Treatment Facility | 4914 West Seneca Turnpkie, Syracuse, NY 13215 | 2015-01-30 |
| 1558771071 | Edleanna Robinson | Licensed Practical Nurse | 5075 W Seneca Turnpike, Syracuse, NY 13215 | 2014-05-06 |
| 1689013450 | Rhonda Lee Philopena | Emergency Medicine | 4900 Broad Rd 1st Fl, Syracuse, NY 13215 | 2013-06-14 |
| 1962778498 | Marie Anne Stevens | Licensed Practical Nurse | 4057 Seneca Tpk, Van Duyn Home and Hospital, Syracuse, NY 13215 | 2012-03-29 |
| 1033439088 | Anna-marie Simpson | Chiropractor | 4922 W Seneca Tpke, Syracuse, NY 13215 | 2010-06-01 |
| 1992028690 | A John Wylie | Pharmacist | 4840 Sherwood Dr., Syracuse, NY 13215 | 2010-03-09 |
| 1669616512 | Asalim A Thabet | Emergency Medicine | 4900 Braod Rd, 1st Fl, Syracuse, NY 13215 | 2009-04-22 |
| 1992948707 | Jesse Reed Gutnick | Surgery | 4900 Borad Rd, Suite 23 North, Syracuse, NY 13215 | 2009-04-08 |
| Find all providers in zip 13215 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679133359 | Nicole Raczkowski | Physician Assistant | 121 Gertrude St Apt 1, Syracuse, NY 13203-2441 | 2019-06-16 |
| 1710544218 | Silver Lining Medical & Consulting, LLC | Physician Assistant | 2876 S 1200 W, Syracuse, UT 84075-8653 | 2019-05-21 |
| 1942779871 | Elizabeth Eileen Chaskey | Physician Assistant | 103 Lockwood Rd, Syracuse, NY 13214-2032 | 2018-11-20 |
| 1316452964 | Merrick Lynne Doody | Physician Assistant | 104 Union Ave # 806-807, Syracuse, NY 13203-1843 | 2017-12-05 |
| 1831640440 | Elana Radin | Physician Assistant | 4440 Ashfield Ter, Syracuse, NY 13215-2463 | 2016-10-18 |
| 1659820835 | Eric Lance Brandenburg | Physician Assistant | 1120 Westmoreland Ave, Syracuse, NY 13210-3161 | 2016-09-28 |
| 1831555747 | Ward Irvin Jr. | Physician Assistant | 104 Union Ave Ste 908, Syracuse, NY 13203-1845 | 2016-01-07 |
| 1497158158 | Jill J Weatherly | Physician Assistant | 4900 Broad Rd Ofc, Syracuse, NY 13215-2265 | 2014-10-08 |
| 1144563800 | Melissa Anne Harnsberger | Physician Assistant | 1000 E Genesee St Ste 300, Syracuse, NY 13210-1853 | 2013-04-01 |
| 1306184403 | Adriane Nicole Arnold | Physician Assistant | 317 S Clinton St, Apt 4d, Syracuse, NY 13202-1216 | 2013-01-23 |
| Find all providers in SYRACUSE | ||||
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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.