LAKE CHAMPLAIN OB/GYN, PC (NPI# 1891708095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891708095 |
| Entity Type | Organization |
| Organization Name | LAKE CHAMPLAIN OB/GYN, PC |
| Practice Address |
206 Cornelia St Suite 306 Plattsburgh NY 12901-2779 |
| Practice Telephone | 5185669452 |
| Practice Fax Number | 5195627189 |
| Mailing Telephone | 5185669452 |
| Mailing Fax Number | 5195627189 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2014-11-03 |
| Authorized Official Name | JEANNIE S VAN NOSTRAND (OFFICE MANAGER) |
| Authorized Official Telephone | 5185669452 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
206 CORNELIA ST SUITE 306 |
| City | PLATTSBURGH |
| State | NY |
| Zip Code | 12901-2779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710983531 | Nancy E Zahn | Nurse Practitioner | 206 Cornelia St, Suite 306, Plattsburgh, NY 12901-2779 | 2005-06-27 |
| 1881139863 | Grant Shannon | Nurse Practitioner | 206 Cornelia St, Suite 105, Plattsburgh, NY 12901-2878 | 2016-12-29 |
| 1437540390 | Gina Kruml | Nurse Practitioner | 206 Cornelia St, Suite 306, Plattsburgh, NY 12901-2779 | 2015-02-13 |
| 1942564299 | Jessica Rose Scott | Nurse Practitioner | 206 Cornelia St, Suite 202, Plattsburgh, NY 12901-2779 | 2012-07-02 |
| 1518284199 | Boris Y Chulpayev | Specialist | 206 Cornelia St, Suite 102, Plattsburgh, NY 12901-2779 | 2010-04-22 |
| 1659606481 | Lauren Ann Caniano | Nurse Practitioner | 206 Cornelia St, 307, Plattsburgh, NY 12901-2779 | 2009-10-13 |
| 1205066180 | Dennis Evgenyevich Radoshkevich | Obstetrics & Gynecology | 206 Cornelia St, Suite 202, Plattsburgh, NY 12901-2779 | 2009-07-25 |
| 1528208881 | Theodore S. Pabst IIi | Surgery | 206 Cornelia St, Suite 104, Plattsburgh, NY 12901-2779 | 2009-02-26 |
| 1770722084 | Charlotte A Gosrich | Nutritionist | 206 Cornelia St, Suite 103, Plattsburgh, NY 12901-2779 | 2009-02-10 |
| 1558514497 | Jessica Rae Hatfield | Physician Assistant | 206 Cornelia St, Suite 104, Plattsburgh, NY 12901-2779 | 2008-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093284721 | Get Movin Inc | Non-emergency Medical Transport (VAN) | 316 Cornelia St, 21a, Plattsburgh, NY 12901 | 2018-11-26 |
| 1528536141 | Inmaculada Ibanez-casas | Technician | Sibley Hall, 113 Rugar Street, Plattsburgh, NY 12901 | 2018-11-13 |
| 1760950372 | Martha R Wasserbauer | Dietetic Technician, Registered | Mountain View Pediatrics, 18 Feathers Drive, Plattsburgh, NY 12901 | 2018-11-13 |
| 1568958411 | Joel Cherian | Student in an Organized Health Care Education/Training Program | 159 Margaret St Ste 100, Plattsburgh, NY 12901 | 2018-07-03 |
| 1396284477 | Florence Reynaud | Acupuncturist | 135 S. Peru Street, Adirondack Integrative Wellness Center, Plattsburgh, NY 12901 | 2017-02-22 |
| 1124565783 | Mytchel Hector | Registered Nurse | 43 Hamilton Street Apt #202, Plattsburgh, NY 12901 | 2017-01-20 |
| 1780136697 | Michael Bruso | Psychologist | 5436 Peru St. Apt. 5, Plattsburgh, NY 12901 | 2016-10-26 |
| 1902357536 | Ashley Patricia Cota | Nurse Practitioner | 214 Cornelia St., Plattsburgh, NY 12901 | 2016-10-19 |
| 1255703310 | Kenneth Wayne Ackley | Licensed Practical Nurse | 16 Ampersand Drive, Plattsbugh, NY 12901 | 2015-10-28 |
| 1275949448 | Shanni Lee Hicks | Specialist | 63 Arnold Rd, Plattsburgh, NY 12901 | 2014-07-08 |
| Find all providers in zip 12901 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418861 | Diane T Cabana | Obstetrics & Gynecology | 8 Broad Street, Plattsburgh, NY 12901-6449 | 2005-06-27 |
| 1558367367 | Susan A Rech | Obstetrics & Gynecology | 25 Degrandpre Way, Plattsburgh, NY 12901-6449 | 2005-06-27 |
| 1528306024 | John Mazur | Obstetrics & Gynecology | 62 Barton Rd, Plattsburgh, NY 12901-7106 | 2013-01-18 |
| 1639484736 | Manal El Daouk | Obstetrics & Gynecology | 8 Broad St, Plattsburgh, NY 12901-3420 | 2010-08-12 |
| 1205066180 | Dennis Evgenyevich Radoshkevich | Obstetrics & Gynecology | 206 Cornelia St, Suite 202, Plattsburgh, NY 12901-2779 | 2009-07-25 |
| 1841420627 | Erica Lynne Bourdeau | Obstetrics & Gynecology | 77 Plaza Blvd, Suite 101, Plattsburgh, NY 12901-3201 | 2009-07-15 |
| 1114125903 | Molly E. Mentzer | Obstetrics & Gynecology | 25 Degrandpre Way, Plattsburgh, NY 12901-6449 | 2007-07-03 |
| 1740404615 | Jessica Veltkamp | Obstetrics & Gynecology | 206 Cornelia St, Suite 306, Plattsburgh, NY 12901-2779 | 2007-04-12 |
| 1700997129 | Natalie Chante Jones | Obstetrics & Gynecology | 1942 Military Tpke, Plattsburgh, NY 12901-7375 | 2006-08-31 |
| 1407811532 | Olof Bernhard Franzon | Obstetrics & Gynecology | 206 Cornelia St, Suite 202, Plattsburgh, NY 12901-2779 | 2006-04-20 |
| Find all providers in PLATTSBURGH | ||||
| City | PLATTSBURGH |
| Zip Code | 12901 |
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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.