MINI SUSAN MAMMEN (NPI# 1780241398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780241398 |
| Entity Type | Individual |
| Full Name | MINI SUSAN MAMMEN |
| Practice Address |
310 E Shore Rd Great Neck NY 11023-2410 |
| Mailing Address |
475 Beech St New Hyde Park NY 11040-3825 |
| Practice Telephone | 5164828657 |
| Mailing Telephone | 7185980529 |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-11-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F344251 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
F344251 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
310 E SHORE RD |
| City | GREAT NECK |
| State | NY |
| Zip Code | 11023-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366440067 | Robert Don Herman | Internal Medicine | 310 E Shore Rd, 206, Great Neck, NY 11023-2432 | 2005-07-07 |
| 1225416969 | Erin Morrissey | Nurse Practitioner | 310 E Shore Rd, Suite 103, Great Neck, NY 11023-2410 | 2015-05-14 |
| 1841694668 | Krystel Salandanan | Psychologist | 310 E Shore Rd, Suite 100, Great Neck, NY 11023-2410 | 2014-10-22 |
| 1881025633 | Howard M. Rombom, Ph.d.,p.c. | Psychologist | 310 E Shore Rd, Suite 100, Great Neck, NY 11023-2410 | 2013-12-04 |
| 1992131833 | Lauren F Stack | Psychologist | 310 E Shore Rd, Suite 100, Great Neck, NY 11023-2410 | 2013-09-24 |
| 1114266145 | Psychology Care PC | Psychologist | 310 E Shore Rd, Great Neck, NY 11023-2410 | 2013-02-12 |
| 1972875946 | Allan I. Stempler, M.d., P.C. | Clinic/Center | 310 E Shore Rd, Suite 301, Great Neck, NY 11023-2410 | 2012-02-06 |
| 1821368689 | Karissa Lynn Maggio | Chiropractor | 310 E Shore Rd, Great Neck, NY 11023-2410 | 2012-01-10 |
| 1083922249 | Allen Lawrence Finkelstein | Dentist | 310 E Shore Rd, Great Neck, NY 11023-2410 | 2010-09-21 |
| 1629383476 | David Rhee | Dentist | 310 E Shore Rd, Suite 101, Great Neck, NY 11023-2410 | 2010-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801355581 | Jennifer Cain | Psychologist | 310 East Shore Rd. Suite 100, Great Neck, NY 11023 | 2019-03-13 |
| 1609346774 | Othniel Physical Therapy PC | Physical Therapist | 444 Middleneck Rd, Suite 1h, Greatneck, NY 11023 | 2018-11-30 |
| 1720403215 | Jason Li | Pharmacist | 125 Maple Street, Great Neck, NY 11023 | 2014-02-20 |
| 1356772156 | Eliian Ramezani | Physical Therapist | 444 Middle Neck Rd Apt 1h, Great Neck, NY 11023 | 2013-12-03 |
| 1710222625 | Jason Sonbolian | Registered Nurse | 22 Chadwick Road, Great Neck, NY 11023 | 2012-12-04 |
| 1659672020 | Marni Rebecca Weinberg | Speech-Language Pathologist | 15 Hutchinson Court, Great Neck, NY 11023 | 2010-11-16 |
| 1568780179 | Dara Bruckner | Physician Assistant | 17 Brokaw Lane, Great Neck, NY 11023 | 2010-05-06 |
| 1205070778 | Rachel Lee Klerer-axelrod | Physical Therapist | 76 Berkshire Road, Great Neck, NY 11023 | 2009-04-28 |
| 1336306455 | Lorrell Heather Zegarelli | Specialist/Technologist | 90 East Shore Road Inside Equinox, Professional Orthopedic and Sports Physical Therapy, Great Neck, NY 11023 | 2008-05-16 |
| 1841471158 | Heikyung Uh | Pharmacist | 152-154 Middle Neck Road, Great Neck, NY 11023 | 2007-11-15 |
| Find all providers in zip 11023 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164890570 | Jaclyn Suzanne Schindler | Nurse Practitioner | 11 Wensley Dr, Great Neck, NY 11021-4916 | 2015-09-02 |
| 1154670131 | Lydia Elizee | Nurse Practitioner | 4519 Iris Ln, Great Neck, NY 11020-1063 | 2012-09-05 |
| 1851677884 | Donna Marie Brook | Nurse Practitioner | 2 Farm Ln, Great Neck, NY 11020-1314 | 2011-10-21 |
| 1134421910 | London A'more Romero | Nurse Practitioner | 833 Northern Blvd Ste 220, Great Neck, NY 11021-5339 | 2010-11-30 |
| 1790396919 | Nicole Pelan | Nurse Practitioner | 1000 Northern Blvd Ste 360, Great Neck, NY 11021-5312 | 2020-08-11 |
| 1013540343 | Peter Magri Jr. | Nurse Practitioner | 1000 Northern Blvd, Great Neck, NY 11021-5338 | 2020-02-14 |
| 1568013795 | Ellie Slivko Beatus | Nurse Practitioner | 865 Northern Blvd Ste 101, Great Neck, NY 11021-5310 | 2019-09-29 |
| 1831752518 | Tannesha Dixon | Nurse Practitioner | 1010 Northern Blvd, Great Neck, NY 11021-5317 | 2019-04-17 |
| 1134618085 | Alicia Dee | Nurse Practitioner | 611 Northern Blvd Ste 150, Great Neck, NY 11021-5207 | 2018-05-07 |
| 1033628292 | Yuna Zyskind | Nurse Practitioner | 51 Great Neck Rd, Great Neck, NY 11021-3333 | 2017-09-20 |
| Find all providers in GREAT NECK | ||||
| City | GREAT NECK |
| Zip Code | 11023 |
Please comment or provide details below to improve the information on MINI SUSAN MAMMEN.
| 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.