JACLYN BASSO (NPI# 1912396219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912396219 |
| Entity Type | Individual |
| Full Name | JACLYN BASSO |
| Credential | MS, RN, CPNP |
| Practice Address |
19 Bradhurst Ave Suite 1400 Hawthorne NY 10532-2140 |
| Mailing Address |
Po Box 1020 Hawthorne NY 10532-7507 |
| Practice Telephone | 9144937997 |
| Practice Fax Number | 9145944022 |
| Mailing Telephone | 8886330033 |
| Mailing Fax Number | 9145931802 |
| Enumeration Date | 2015-01-10 |
| Last Update Date | 2015-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
382226 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
19 BRADHURST AVE SUITE 1400 |
| City | HAWTHORNE |
| State | NY |
| Zip Code | 10532-2140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437152618 | Martin Cohen | Internal Medicine | 19 Bradhurst Ave, Ste 3850s, Hawthorne, NY 10532-2140 | 2005-05-23 |
| 1194368472 | Susan Eleanora Russo | Dietitian, Registered | 19 Bradhurst Ave, Hawthorne, NY 10532-2140 | 2019-10-19 |
| 1326536434 | Amanda Elizabeth Muldoon | Audiologist | 19 Bradhurst Ave, Hawthorne, NY 10532-2140 | 2018-04-24 |
| 1992252662 | Daniela Levin | Physician Assistant | 19 Bradhurst Ave, Ste 3050n, Hawthorne, NY 10532-2140 | 2016-09-09 |
| 1831564616 | Diane Lindsay-adler | Dietitian, Registered | 19 Bradhurst Ave, Hawthorne, NY 10532-2140 | 2015-12-05 |
| 1730551755 | Alessandra Marino | Physician Assistant | 19 Bradhurst Ave, Suite 2575, Hawthorne, NY 10532-2140 | 2015-10-29 |
| 1093190043 | Adedoyin Solomon | Nurse Practitioner | 19 Bradhurst Ave, Suite 2300, Hawthorne, NY 10532-2140 | 2015-07-20 |
| 1073919874 | Jessica Hoffman | Audiologist | 19 Bradhurst Ave, Ste 3600s, Hawthorne, NY 10532-2140 | 2014-11-06 |
| 1841693413 | Amy Sue Habeck | Dietitian, Registered | 19 Bradhurst Ave, Suite 1700, Hawthorne, NY 10532-2140 | 2014-09-26 |
| 1548669369 | Samantha Wenta | Physician Assistant | 19 Bradhurst Ave, Suite 3040n, Hawthorne, NY 10532-2140 | 2014-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447792924 | Avril Dunbar | Registered Nurse | 228-500 Linda Ave, Hawthorne, NY 10532 | 2016-11-15 |
| 1134572704 | Ronald Tomlinson Jr. | Licensed Practical Nurse | 228- 500 Linda Avenue, Hawthorne, NY 10532 | 2016-07-19 |
| 1831566843 | Noble A Thomas | Chiropractor | 153 Broadway Ste 1, Hawthorne, NY 10532 | 2015-08-25 |
| 1790169068 | Sheila Astorino | Case Manager/Care Coordinator | 281 Pythian Avenue, Hawthorne, NY 10532 | 2015-07-16 |
| 1962801381 | Edison Pena | Student in an Organized Health Care Education/Training Program | 2226 Linda Avenue, Hawthorne, NY 10532 | 2014-08-21 |
| 1093029720 | Kathleen B Shaps | Registered Nurse | 226 Linda Avenue, Hawthorne, NY 10532 | 2010-08-05 |
| 1457580839 | Tracey Leah Shannon | Nurse Practitioner | 19 Bradhurst Ave Ste 3850s, Hawthorne, NY 10532 | 2009-07-07 |
| 1033364930 | Aldo Joseph Porco Md | Psychiatry & Neurology | 500 Linda Ave., Hawthorne, NY 10532 | 2008-11-20 |
| 1164675443 | Joanne Mary Bortone | Occupational Therapist | 1 Skyline Drive Suite 298, Kidabilities, Hawthorne, NY 10532 | 2008-10-30 |
| 1306094420 | Jeffrey Scott Anderson | Counselor | 226 Linda Ave., Hawthorne, NY 10532 | 2008-09-03 |
| Find all providers in zip 10532 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922252238 | Louise M Danzig | Nurse Practitioner | 19 Bradhurst Ave, Suite 1400, Hawthorne, NY 10532-2140 | 2008-11-13 |
| 1760526610 | Ellen Jo Fasanaro | Nurse Practitioner | 1114 Goffle Rd, Hawthorne, NJ 07506-2014 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709821 | Shu-heng Wang | Nurse Practitioner | 7324 18th Ave, Brooklyn, NY 11204-5678 | 2020-10-29 |
| 1952909012 | Marina Byshovets | Nurse Practitioner | 164 Admiralty Loop, Staten Island, NY 10309-3964 | 2020-10-12 |
| 1700483799 | Dmitry Pediatrics, Pediatric Nurse Practitioner PC | Nurse Practitioner | 10 Shore Blvd Apt 1g, Brooklyn, NY 11235-4022 | 2020-10-03 |
| 1427664572 | Leigh Ann Cohen | Nurse Practitioner | 2 Lincoln Ave Ste 301, Rockville Centre, NY 11570-5775 | 2020-09-23 |
| 1295341436 | Tatiana Margaret Masone | Nurse Practitioner | 3142 Victory Blvd, Staten Island, NY 10314-6717 | 2020-09-22 |
| 1992311567 | Jyneva W Pickel | Nurse Practitioner | 3959 Broadway Rm 722, New York, NY 10032-1559 | 2020-09-19 |
| 1902410186 | Katie Elise Boyd | Nurse Practitioner | 725 Irving Ave Ste 504, Syracuse, NY 13210-1683 | 2020-09-03 |
| 1437763877 | Tiffany Yu | Nurse Practitioner | 1746 W 12th St, Brooklyn, NY 11223-1101 | 2020-09-02 |
| 1134733710 | Khristan Heagle Haller | Nurse Practitioner | 20 Locust Ln, Bronxville, NY 10708-4933 | 2020-09-01 |
| 1831703412 | Marijana Waite | Nurse Practitioner | 6544 Saunders St Apt A7, Rego Park, NY 11374-4209 | 2020-09-01 |
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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.