JEFFREY WAITKUS (NPI# 1912142670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912142670 |
| Entity Type | Individual |
| Full Name | JEFFREY WAITKUS |
| Practice Address |
23 Central Ave Lynn MA 01901-1220 |
| Mailing Address |
269 Union St Lynn MA 01901-1314 |
| Practice Telephone | 7814777222 |
| Practice Fax Number | 7815963966 |
| Mailing Telephone | 7814777222 |
| Mailing Fax Number | 7815963966 |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2008-12-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
23 CENTRAL AVE |
| City | LYNN |
| State | MA |
| Zip Code | 01901-1220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750595609 | Summer Baidak | Counselor | 23 Central Ave, Lynn, MA 01901-1220 | 2007-05-10 |
| 1124325592 | Jeffrey Downey | Counselor | 23 Central Ave, Lynn, MA 01901-1220 | 2011-02-22 |
| 1053614974 | Robin A Ronchi | Counselor | 23 Central Ave, Suite 301, Lynn, MA 01901-1220 | 2010-12-15 |
| 1912215120 | Lynn Community Health, Inc. | Clinic/Center | 23 Central Ave, Lynn, MA 01901-1220 | 2010-09-22 |
| 1568779932 | Rachel Goldman Dale | Psychologist | 23 Central Ave, Lynn, MA 01901-1220 | 2010-09-08 |
| 1104133750 | Matthew Twomey | Nurse Practitioner | 23 Central Ave, Lynn, MA 01901-1220 | 2010-09-02 |
| 1184958480 | Kate Vitt Fogarty | Clinical Nurse Specialist | 23 Central Ave, Lynn, MA 01901-1220 | 2009-09-21 |
| 1366687782 | Argentina Moreta | Counselor | 23 Central Ave, Lynn, MA 01901-1220 | 2008-12-15 |
| 1902041833 | Debra Newborg | Psychologist | 23 Central Ave, Lynn, MA 01901-1220 | 2008-12-05 |
| 1255576153 | Zachary Blumkin | Psychologist | 23 Central Ave, Lynn, MA 01901-1220 | 2008-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427515923 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 173 Oxford Street, Lowel Level, Suite P, Lynn, MA 01901 | 2019-02-21 |
| 1730680125 | Sarah Sawulski | Registered Nurse | 269 Union Stree01901t, Lynn, MA 01901 | 2018-02-22 |
| 1184142895 | Adrienne Wood | Case Manager/Care Coordinator | 100 Willow Street, Lynn, MA 01901 | 2017-09-01 |
| 1831613199 | Marie Linda Yannaco-grant | Social Worker | 62 Market Street, Lynn, MA 01901 | 2017-07-28 |
| 1942723457 | Michael Xinyu Miao | Physical Therapy Assistant | 1 Market Street, 3rd Floor, Lynn, MA 01901 | 2017-07-18 |
| 1730544743 | Pediatric Dental Professionals LLC | Dentist | 391 Lynn Way, Bldg A, Lynn, MA 01901 | 2015-12-17 |
| 1346667748 | Emily G. Joseph | Social Worker | 112 Market Street, 2nd Floor, Lynn, MA 01901 | 2014-03-24 |
| 1548510621 | Serena M Smith | Counselor | 181 Union Street, Suite J, Lynn, MA 01901 | 2012-09-14 |
| 1043575624 | Timothy J Bossie | Optometrist | 20 Central Avenue, Lynn, MA 01901 | 2012-07-10 |
| 1689946923 | Lynn Dental Center | Dentist | 232 Union Street, Lynn, MA 01901 | 2012-02-02 |
| Find all providers in zip 01901 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730791823 | Aldo Mali | Student in an Organized Health Care Education/Training Program | 16 Rand St, Lynn, MA 01904-2914 | 2020-08-19 |
| 1750999439 | Francky L Beaubrun | Student in an Organized Health Care Education/Training Program | 17 Glen Ct, Lynn, MA 01905-1853 | 2020-07-17 |
| 1285087866 | Anis Pichardo | Student in an Organized Health Care Education/Training Program | 95 Pleasant St # 1, Lynn, MA 01901-1524 | 2016-07-19 |
| 1992932180 | Bobby Siharath | Student in an Organized Health Care Education/Training Program | 285 Summer St, Lynn, MA 01902-4503 | 2009-06-16 |
| 1528606738 | Alessandra Christine Frissora | Student in an Organized Health Care Education/Training Program | 269 Union St, Lynn, MA 01901-1314 | 2019-12-18 |
| 1043782717 | Kannika Chap | Student in an Organized Health Care Education/Training Program | 20 Central Ave, Lynn, MA 01901-1201 | 2018-12-19 |
| 1568931459 | Cindi C Flores | Student in an Organized Health Care Education/Training Program | 20 Central Ave, Lynn, MA 01901-1201 | 2018-11-20 |
| 1477021632 | Elyse Taylor Mccue | Student in an Organized Health Care Education/Training Program | 181 Union St, Lynn, MA 01901-1311 | 2018-11-06 |
| 1295202851 | Elizabeth Mary Currier | Student in an Organized Health Care Education/Training Program | 269 Union St, Lynn, MA 01901-1314 | 2018-10-31 |
| 1275017618 | Kathryn Thibedeau | Student in an Organized Health Care Education/Training Program | 269 Union Street, Lynn Community Health Center, Lynn, MA 01901 | 2018-09-21 |
| Find all providers in LYNN | ||||
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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.