MID NASSAU MEDICAL CARE FOR KIDZ, LLC (NPI# 1710356043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710356043 |
| Entity Type | Organization |
| Organization Name | MID NASSAU MEDICAL CARE FOR KIDZ, LLC |
| Practice Address |
530 Old Country Rd Suite 1b Westbury NY 11590-4500 |
| Practice Telephone | 5163337272 |
| Practice Fax Number | 5163332519 |
| Mailing Telephone | 5163337272 |
| Mailing Fax Number | 5163332519 |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |
| Authorized Official Name | STEVEN PERRICK (M.D./PARTNER) |
| Authorized Official Telephone | 5163337272 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MID NASSAU MEDICAL CARE FOR KID |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 8307806 | 05 | |
| NY | 0218647 | 05 |
| Street Address |
530 OLD COUNTRY RD SUITE 1B |
| City | WESTBURY |
| State | NY |
| Zip Code | 11590-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932292075 | Farhan N Masani | Podiatrist | 530 Old Country Rd, Suite 2g, Westbury, NY 11590 | 2006-10-02 |
| 1427352111 | Earl S Dorfman Dds PC | Dentist | 530 Old Country Rd, Suite 2f, Westbury, NY 11590-4500 | 2011-01-10 |
| 1578732657 | Farhan N Masani Dpm PC | Podiatrist | 530 Old Country Rd, Suite 2g, Westbury, NY 11590-4500 | 2008-02-22 |
| 1699862151 | Doris Gomez | Nurse Practitioner | 530 Old Country Rd, Westbury, NY 11590-4500 | 2006-10-06 |
| 1235226754 | Westbury Family Medical | Family Medicine | 530 Old Country Rd, 2a, Westbury, NY 11590-4500 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940167 | Jacqueline Belinda Trichter | Specialist | 1400 Old Old Country Rd, Suite C103n, Westbury, NY 11590 | 2020-10-22 |
| 1306486501 | Tesa S Etchieson | Case Manager/Care Coordinator | 1400 Old Country Road Suite C103-n, Westbury, NY 11590 | 2020-01-15 |
| 1134762685 | Melissa Barry | Behavioral Analyst | 19 Sherman Street, Westbury, NY 11590 | 2019-10-28 |
| 1538713060 | Li Chen | Massage Therapist | 97 Post Ave, Westbury, NY 11590 | 2019-08-01 |
| 1942787320 | Ketsia Desrosiers | Registered Nurse | 1610 Old Country Road, Westbury, NY 11590 | 2018-07-27 |
| 1710472782 | Long Island Heart and Vascular Specialist PC | Internal Medicine | 1600 Stewart Ave Ste 105, Westbury, NY 11590 | 2018-06-22 |
| 1669962791 | Viji Joseph Meledath | Nurse Practitioner | 38 Fawn Ln, Westbury, NY 11590 | 2018-05-15 |
| 1093217911 | Orthotic Services for Children, Inc. | Orthotist | 811a Carman Ave., Westbury, NY 11590 | 2018-03-07 |
| 1356884431 | Aurus Service Center of New York, LLC | Early Intervention Provider Agency | 39 Pilgrim Lane, Westbury, NY 11590 | 2016-11-22 |
| 1376099598 | Kelly Eulner-tripodi | Social Worker | 50 East Asbury Ave, Westbury, NY 11590 | 2016-08-28 |
| Find all providers in zip 11590 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420472 | Theodean Smith-lawrence | General Practice | 7 Smoke Rise Ln, Wappingers Falls, NY 12590-1220 | 2020-09-03 |
| 1891304325 | Christopher R. Page, M.d., Pllc | General Practice | 46 Route 25a Ste 6, Setauket, NY 11733-2807 | 2020-07-30 |
| 1740804442 | Aliza Hakimian | General Practice | 15 Hill Park Ave Apt 2n, Great Neck, NY 11021-3709 | 2020-05-29 |
| 1962022152 | Lynnette Lallave - Cortes | General Practice | 2 Seaman Ave Apt 1d, New York, NY 10034-2904 | 2020-04-17 |
| 1942829759 | Northeasttelemedicine | General Practice | 483 Coolidge Hill Rd, Diamond Point, NY 12824 | 2020-04-11 |
| 1578198826 | Online Care Medicine PC | General Practice | 26 Oldox Rd, Delmar, NY 12054-2943 | 2020-03-06 |
| 1821621301 | Donnet Andrea Riley | General Practice | 781 Palmer Rd Apt 3a, Bronxville, NY 10708-3309 | 2020-02-12 |
| 1104463652 | Ohad Shimshon Bentur | General Practice | 450 E 63rd St Apt 3g, New York, NY 10065-7957 | 2019-12-03 |
| 1285278291 | Echo Clinical Associates LLC | General Practice | 56 Echo Ave., Ste 1, Miller Place, NY 11764-2454 | 2019-11-01 |
| 1710528583 | Debra Heverly | General Practice | 2315 Whirlpool St # 415, Niagara Falls, NY 14305-2413 | 2019-10-03 |
| 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.