DR. LISA LAROCCA-HULSEN (NPI# 1740373802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740373802 |
| Entity Type | Individual |
| Full Name | DR. LISA LAROCCA-HULSEN |
| Credential | D.P.M. |
| Practice Address |
260 Middle Country Rd Suite 104 Smithtown NY 11787-2982 |
| Practice Telephone | 6317241166 |
| Practice Fax Number | 6317244130 |
| Mailing Telephone | 6317241166 |
| Mailing Fax Number | 6317244130 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2011-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | N005415 | NY | Podiatric Medicine & Surgery Service Providers |
| Street Address |
260 MIDDLE COUNTRY RD SUITE 104 |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-2982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157948 | Stephen Daniel Shappell | Specialist | 260 Middle Country Rd, Suite 214, Smithtown, NY 11787-2982 | 2005-07-08 |
| 1902138233 | Thomas R Scott | Pharmacist | 260 Middle Country Rd, Suite 105, Smithtown, NY 11787 | 2010-02-11 |
| 1396077335 | Thomas Gee | Pharmacist | 260 Middle Country Rd, Smithtown, NY 11787-2982 | 2010-02-01 |
| 1871722587 | Jill A Ryan | Nurse Practitioner | 260 Middle Country Rd, 214, Smithtown, NY 11787-2982 | 2009-07-02 |
| 1053579524 | Jennifer Cassidy | Nurse Practitioner | 260 Middle Country Rd, Suite 214, Smithtown, NY 11787-2982 | 2008-05-30 |
| 1093973778 | Marjorie C. Ravitz Dpm PC | Podiatrist | 260 Middle Country Rd, Suite 104, Smithtown, NY 11787-2982 | 2008-05-29 |
| 1497960751 | Carder Kelly | Specialist | 260 Middle Country Rd, Smithtown, NY 11787-2982 | 2007-05-11 |
| 1073735593 | Michael Fastenberg | Dermatology | 260 Middle Country Rd, Suite 208, Smithtown, NY 11787-2982 | 2007-05-03 |
| 1619067899 | Lisa Schirripa | Podiatrist | 260 Middle Country Rd, Ste 104, Smithtown, NY 11787 | 2006-10-16 |
| 1942211081 | Lawrence Zweibel | Ophthalmology | 260 Middle Country Rd, Suite 201, Smithtown, NY 11787 | 2006-08-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
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| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396190740 | Christina Fereshta Nawabi | Podiatrist | 2 Brooksite Dr Ste 230, Smithtown, NY 11787-3492 | 2016-05-03 |
| 1144487737 | Robert W Einhorn | Podiatrist | 355 Route 111 Unit 41, Smithtown, NY 11787-4748 | 2008-05-21 |
| 1154397594 | Dennis Michael Illuzzi | Podiatrist | 61 Route 111, Smithtown, NY 11787-3712 | 2006-02-26 |
| 1386615342 | Wendy R Young-gomerman | Podiatrist | 222 E Middle Country Rd Ste 209, Smithtown, NY 11787-2814 | 2006-01-30 |
| 1992706287 | Kenneth Eugene Coombs | Podiatrist | 154 Terry Rd, Smithtown, NY 11787-5103 | 2005-08-09 |
| 1366444317 | Ronald A Washington | Podiatrist | 2 Brooksite Dr, Ste. 230, Smithtown, NY 11787-3492 | 2005-06-02 |
| 1922322932 | Wendy S. Siegel, Dpm Pllc | Podiatrist | 319 Middle Country Rd, Suite 5, Smithtown, NY 11787-2819 | 2010-03-19 |
| 1093973778 | Marjorie C. Ravitz Dpm PC | Podiatrist | 260 Middle Country Rd, Suite 104, Smithtown, NY 11787-2982 | 2008-05-29 |
| 1093984577 | Harvey A Freedman Dpm PC | Podiatrist | 154 Terry Rd, Smithtown, NY 11787-5103 | 2008-02-28 |
| 1619067899 | Lisa Schirripa | Podiatrist | 260 Middle Country Rd, Ste 104, Smithtown, NY 11787 | 2006-10-16 |
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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.