SUELLEN NELSON (NPI# 1811025257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811025257 |
| Entity Type | Individual |
| Full Name | SUELLEN NELSON |
| Credential | P.A.-C |
| Practice Address |
969 Main St Suite D Fishkill NY 12524 |
| Mailing Address |
969 Main St Ste D Fishkill NY 12524-1791 |
| Practice Telephone | 8458967730 |
| Mailing Telephone | 8458967730 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2018-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
003700 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
000463 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 04956290 | 05 | |
| NY | MEDICARE PTAN | A400085151 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 29 Fox St Fl 4, Poughkeepsie, NY 126014732 | 8454732350 | 8454734305 |
| Street Address |
969 MAIN ST SUITE D |
| City | FISHKILL |
| State | NY |
| Zip Code | 12524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134112030 | Gary M Weiner | Optometrist | 969 Main St, Suite H, Fishkill, NY 12524-1789 | 2005-08-25 |
| 1265917512 | Lewis J Sims Dpm P.C. | Podiatrist | 969 Main St, Fishkill, NY 12524-1789 | 2018-10-02 |
| 1255888079 | Premier Medical Group of The Hudson Valley, P.C. | Podiatrist | 969 Main St, Fishkill, NY 12524-1789 | 2016-09-09 |
| 1366792301 | Dr. Yashodhara Misra Ob-gyn PC | Obstetrics & Gynecology | 969 Main St, Fishkill, NY 12524-1789 | 2012-09-18 |
| 1467783076 | Elite Woman's Care LLC | Obstetrics & Gynecology | 969 Main St, Fishkill, NY 12524-1789 | 2010-01-21 |
| 1538289988 | Lasha Jaiani | Dermatology | 969 Main St, Suite D, Fishkill, NY 12524 | 2007-03-30 |
| 1407870165 | Angela Amada Crosdale | Specialist | 969 Main St, Fishkill, NY 12524-1789 | 2006-07-27 |
| 1508895384 | Hudson Dermatology, PC | Dermatology | 969 Main St, Suite D, Fishkill, NY 12524 | 2006-07-02 |
| 1598721912 | Herbert Paul Goodheart | Specialist | 969 Main St, Suite D, Fishkill, NY 12524-1789 | 2006-04-25 |
| 1194781039 | Hendrik Ivo Uyttendaele | Specialist | 969 Main St, Suite D, Fishkill, NY 12524 | 2006-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306392659 | Leandra Carr | Licensed Practical Nurse | 3 Mountain View Knolls Drive, Fishkill, NY 12524 | 2016-08-28 |
| 1558738427 | Teresa Williams | Speech-Language Pathologist | 51 Shirley Ave, Fishkill, NY 12524 | 2015-08-27 |
| 1689088742 | Cardiovascular and Medical Associate of The Hudson Valley PC | Internal Medicine | 841 Route 52 Suite 6, Fishkill, NY 12524 | 2014-06-17 |
| 1366876377 | Bohdan Darnobid | Physician Assistant | 121 Red School House Road, Fishkill, NY 12524 | 2013-08-27 |
| 1396007530 | Rebecca Gowans Roper-eckstein | Psychologist | 24 Old Glenham Road, Fishkill, NY 12524 | 2012-06-13 |
| 1083989859 | Nicos Nicolaou | Pathology | 400 Westage Business Ctr Dr Ste 209, Fishkill, NY 12524 | 2012-03-13 |
| 1760776256 | Janice Jacqueline Thomas-green | Registered Nurse | 62 Hoose Blvd, Fishkill, NY 12524 | 2011-06-02 |
| 1548494776 | Jacquelyn A Lindsay | Social Worker | 1575 Route 376 At New Hackensack Road, Wappingers Falls, NY 12524 | 2009-05-01 |
| 1154512838 | Joan J Miles | Registered Nurse | 74 Highland Ct, Fishkill, NY 12524 | 2007-08-07 |
| 1902097884 | Optical Fashions Corp | Technician/Technologist | 200 Westage Business Center Drive, Fishkill, NY 12524 | 2007-08-06 |
| Find all providers in zip 12524 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366876377 | Bohdan Darnobid | Physician Assistant | 121 Red School House Road, Fishkill, NY 12524 | 2013-08-27 |
| 1134340144 | Kara Veit | Physician Assistant | 200 Westage Business Center, Suite 231, Fishkill, NY 12524-0000 | 2007-05-01 |
| 1588213789 | Aimee Ann Gifford | Physician Assistant | 600 Westage Business Ctr Dr, Fishkill, NY 12524-2281 | 2019-09-10 |
| 1699116129 | Courtney Jo Lina Moreau | Physician Assistant | 400 Westage Business Ctr Dr, Fishkill, NY 12524-2223 | 2013-07-12 |
| 1235471616 | Andrew Pietris | Physician Assistant | 60 Merritt Blvd, Suite 106, Fishkill, NY 12524-2917 | 2013-03-23 |
| 1881969004 | Caroline M Raftopol | Physician Assistant | 969 Main St Ste D, Fishkill, NY 12524-1791 | 2012-03-21 |
| 1730412784 | Elizabeth Lee Lemke | Physician Assistant | 400 Westage Business Ctr Dr Ste 205, Fishkill, NY 12524-2266 | 2009-09-09 |
| 1942216825 | John David Haldeman | Physician Assistant | 400 Westage Business Ctr Dr, Suite 210, Fishkill, NY 12524-2223 | 2006-07-31 |
| 1073527115 | Scott Markumas | Physician Assistant | 400 Westage Business Ctr Dr, Suite 210, Fishkill, NY 12524-2223 | 2006-07-27 |
| 1548229776 | Deborah Scannell I | Physician Assistant | 600 Westage Business Ctr Dr, Fishkill, NY 12524-2281 | 2006-03-17 |
| Find all providers in FISHKILL | ||||
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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.