IZABELLA DYAKOVETSKY MD, LLC (NPI# 1932360559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932360559 |
| Entity Type | Organization |
| Organization Name | IZABELLA DYAKOVETSKY MD, LLC |
| Practice Address |
201 Lakeside Park Ste B Southampton PA 18966-4049 |
| Practice Telephone | 2153229020 |
| Practice Fax Number | 2153229040 |
| Mailing Telephone | 2153229020 |
| Mailing Fax Number | 2153229040 |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2008-06-17 |
| Authorized Official Name | IZABELLA DYAKOVETSKY (PRESEDENT) |
| Authorized Official Telephone | 2153229020 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
201 LAKESIDE PARK STE B |
| City | SOUTHAMPTON |
| State | PA |
| Zip Code | 18966-4049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942460753 | Eugene Dyakovetsky Md. LLC | Clinic/Center | 201 Lakeside Park, Ste A, Southampton, PA 18966-4049 | 2008-06-16 |
| 1669983193 | Alina Tsirelson | Counselor | 201 Lakeside Park, Southampton, PA 18966-4049 | 2017-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033758636 | Nancy Rubin | Speech-Language Pathologist | Nancy Rubin, 32 Brook Drive, Southampton, PA 18966 | 2019-12-30 |
| 1265970669 | Dominic Bogucki | Specialist/Technologist | 75 Meadowfield Dr, Southampton, PA 18966 | 2017-02-06 |
| 1518404359 | Amanda Phillips | Social Worker | 504 Lakeside Office Park, Suite 504, Southampton, PA 18966 | 2017-01-31 |
| 1386988830 | Sara Beth Bergman | Occupational Therapy Assistant | 1354 Hi View Drive, Southampton, PA 18966 | 2012-11-22 |
| 1326325523 | Annie Varughese | Pharmacist | 139 Lark Dr, Holland, PA 18966 | 2011-11-16 |
| 1912284993 | Christine Renee Nichols | Social Worker | 1030 Second Street Pike, Southampton, PA 18966 | 2011-11-04 |
| 1407134125 | Apex Smiles LLC | Dentist | 771 2nd Street Pike, Southampton, PA 18966 | 2011-07-29 |
| 1790092708 | The Comprehensive Learning Center, Inc. | Community/Behavioral Health | 150 James Way, Southampton, PA 18966 | 2010-09-13 |
| 1861713786 | Austin Patrick Daly | Dentist | 404 Lakeside Park, Southampton, PA 18966 | 2010-06-15 |
| 1164660015 | Andrew J Sohl | Podiatrist | 86 Buck Rd Ste 2, Southampton, PA 18966 | 2009-01-30 |
| Find all providers in zip 18966 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386021087 | Rediclinic of Pa, LLC | Clinic/Center | 1035 County Line Rd., Southampton, PA 19006-1206 | 2015-05-01 |
| 1124334099 | East-west Wellness Center | Clinic/Center | 649 2nd Street Pike Ste B, Southampton, PA 18966-3996 | 2010-08-29 |
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| 1376161828 | Cerner Health Connections, Inc | Clinic/Center | 1234 West Chester Pike, West Chester, PA 19382-5688 | 2020-07-10 |
| 1811514417 | Care Counseling & Children's Services LLC | Clinic/Center | 872 Pennsylvania St, Whitehall, PA 18052-7968 | 2020-06-30 |
| 1629694880 | Lancaster General Medical Group | Clinic/Center | 2112 Harrisburg Pike Ste 323, Lancaster, PA 17601-2644 | 2020-06-23 |
| 1225653496 | Aeo Pitt | Clinic/Center | 77 Hot Metal St, Pittsburgh, PA 15203-2382 | 2020-06-12 |
| 1174147656 | Paul Witt Do Pllc | Clinic/Center | 59 East Carey Street, Plains, PA 18705-1870 | 2020-06-01 |
| 1306469309 | Everest Pace Center Inc | Clinic/Center | 2602 W 9th St Ste 100, Chester, PA 19013-2089 | 2020-05-26 |
| 1225650930 | The Modern Country Doctor, LLC | Clinic/Center | 23 Industrial Blvd Ste D, Paoli, PA 19301-1601 | 2020-05-15 |
| 1013543099 | Rediclinic of Pa, LLC | Clinic/Center | 5707 Easton Rd, Pipersville, PA 18947-1823 | 2020-03-21 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHAMPTON |
| Zip Code | 18966 |
Please comment or provide details below to improve the information on IZABELLA DYAKOVETSKY MD, LLC.
| 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.