MICHAEL MINCOLLA (NPI# 1851546014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851546014 |
| Entity Type | Individual |
| Full Name | MICHAEL MINCOLLA |
| Credential | MC |
| Practice Address |
4939 Brittonfield Pkwy East Syracuse NY 13057-9208 |
| Mailing Address |
4939 Brittonfield Parkway East Syracuse NY 13057-9208 |
| Practice Telephone | 3154631600 |
| Practice Fax Number | 3156346795 |
| Mailing Telephone | 3154631600 |
| Mailing Fax Number | 3156346795 |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2011-11-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 261562 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03359208 | 05 |
| Street Address |
4939 BRITTONFIELD PKWY |
| City | EAST SYRACUSE |
| State | NY |
| Zip Code | 13057-9208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205364940 | Michael Fiacco | Family Medicine | 4939 Brittonfield Pkwy, East Syracuse, NY 13057-9208 | 2017-05-25 |
| 1306394713 | Margaret Gambee Sweet | Physician Assistant | 4939 Brittonfield Pkwy, Suite 202, East Syracuse, NY 13057-9208 | 2016-09-14 |
| 1265823306 | Stacey Michelle Cook | Physician Assistant | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2015-02-11 |
| 1659702314 | Lyndsay Raasch | Physician Assistant | 4939 Brittonfield Pkwy, Bldg B., Ste. 210, East Syracuse, NY 13057-9208 | 2013-12-06 |
| 1265869648 | Kevin James Smith | Physician Assistant | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2013-10-01 |
| 1730443003 | Anthony John Malvasi | Family Medicine | 4939 Brittonfield Pkwy, East Syracuse, NY 13057-9208 | 2012-07-01 |
| 1518292333 | Theresa Mary Lucason | Physician Assistant | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2009-10-13 |
| 1376788588 | Amy Lynn Russell | Physician Assistant | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057 | 2008-12-03 |
| 1578718730 | Stephanie Anne Clapper | Family Medicine | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2008-12-01 |
| 1588819734 | James L Tarala | Family Medicine | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2008-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891335527 | Amanda Christian | Clinic/Center | Hcr Home Care- 6007 Fair Lakes Rd, East Syracuse, NY 13057 | 2020-01-10 |
| 1437690104 | Wojtyna Dental LLC | Dentist | 6600 Weighlock Drive, East Syracuse, NY 13057 | 2017-03-15 |
| 1538609854 | Marie Elena Dow | Health Educator | 6576 Kirkville Road, East Syracuse, NY 13057 | 2017-03-06 |
| 1821534470 | Maureen Lanious | Massage Therapist | 6701 Manlius Center Road, Avanti Healing Arts, East Syracuse, NY 13057 | 2017-01-06 |
| 1629526058 | A Woman's Resource | Home Health | 5860 Bowman Road, East Syracuse, NY 13057 | 2016-09-14 |
| 1386029221 | Apollo Physical Therapy, Pllc | Physical Therapist | 6304 Carrier Parkway, East Syracuse, NY 13057 | 2015-07-21 |
| 1457734386 | Podiatry Services of Central New York, PC | Podiatrist | 6647 Kirkville Road, East Syracuse, NY 13057 | 2015-07-09 |
| 1730592163 | Plev Bc Plc | Dentist | 6600 Weighlock Dr, East Syracuse, NY 13057 | 2014-06-03 |
| 1821418740 | Kelsey Spradlin | Speech-Language Pathologist | 6400 Fremont Rd, East Syracuse, NY 13057 | 2014-04-17 |
| 1992044945 | Sizewise Rentals | Durable Medical Equipment & Medical Supplies | 6504 Basile Rowe, East Syracuse, NY 13057 | 2013-02-12 |
| Find all providers in zip 13057 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750384020 | Karen E Beckman | Family Medicine | 4939 Brittonfield Parkway, East Syracuse, NY 13057 | 2005-05-31 |
| 1548820335 | Thresa M Myers | Family Medicine | 4939 Brittonfield Pkwy Ste 101, East Syracuse, NY 13057-9208 | 2019-06-14 |
| 1992363550 | Jonathan Joseph Sicilia | Family Medicine | 4939 Brittonfield Pkwy Ste 101, East Syracuse, NY 13057-9208 | 2019-05-30 |
| 1407339096 | Aubrey Lynn Letourneau | Family Medicine | 4939 Brittonfield Pkwy Ste 101, East Syracuse, NY 13057-9208 | 2018-09-11 |
| 1396230652 | Ashley F Zalewski | Family Medicine | 4939 Brittonfield Pkwy Ste 101, East Syracuse, NY 13057-9208 | 2018-06-28 |
| 1205364940 | Michael Fiacco | Family Medicine | 4939 Brittonfield Pkwy, East Syracuse, NY 13057-9208 | 2017-05-25 |
| 1164803102 | Nicholas J. Augustine | Family Medicine | 4939 Brittonfield Pkwy Ste 101, East Syracuse, NY 13057-9208 | 2015-06-16 |
| 1629459664 | Christopher Adiletta | Family Medicine | 4939 Brittonfield Pkwy Ste 101, East Syracuse, NY 13057 | 2015-06-16 |
| 1467793273 | Andrew P Hathaway | Family Medicine | 5000 Brittonfield Pkwy Ste A100, East Syracuse, NY 13057-9227 | 2013-03-05 |
| 1730443003 | Anthony John Malvasi | Family Medicine | 4939 Brittonfield Pkwy, East Syracuse, NY 13057-9208 | 2012-07-01 |
| Find all providers in EAST SYRACUSE | ||||
| City | EAST SYRACUSE |
| Zip Code | 13057 |
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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.