MS. MARTHA L KETTERIDGE (NPI# 1952488454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952488454 |
| Entity Type | Individual |
| Full Name | MS. MARTHA L KETTERIDGE |
| Other Name | MARTHA L OUTCAULT |
| Credential | N.P |
| Practice Address |
210 E Main St Ste 5 Huntington NY 11743-2979 |
| Practice Telephone | 6318641795 |
| Practice Fax Number | 6318641795 |
| Mailing Telephone | 6318641795 |
| Mailing Fax Number | 6318641795 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-03-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | F400635 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
F400635 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
210 E MAIN ST STE 5 |
| City | HUNTINGTON |
| State | NY |
| Zip Code | 11743-2979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699775312 | Patrick Barnett Burns | Family Medicine | 210 E Main St, Huntington, NY 11743-2979 | 2005-07-22 |
| 1093128407 | Sarah Dissler Ohlinger | Dietitian, Registered | 210 E Main St, Huntington, NY 11743-2979 | 2014-06-04 |
| 1124311725 | Andrea E Sinka | Physician Assistant | 210 E Main St, Huntington, NY 11743-2979 | 2011-05-16 |
| 1801964242 | Jennifer Regeer | Nurse Practitioner | 210 E Main St, Huntington, NY 11743-2979 | 2006-12-02 |
| 1487761276 | Mary Kiernan-tighe | Social Worker | 210 E Main St, Huntington, NY 11743-2979 | 2006-08-25 |
| 1609876325 | Lorraine Frances Burns | Family Medicine | 210 E Main St, Huntington, NY 11743-2979 | 2005-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896477 | Peter C Gaal | Behavioral Analyst | 47 N. Woodhull Road, 2nd Floor, Huntington, NY 11743 | 2019-11-25 |
| 1902389299 | Taylor Bliss Dambrosio | Early Intervention Provider Agency | 38 Carnegie Ave, Huntington, NY 11743 | 2018-09-12 |
| 1639601750 | Speech and Hearing Services | Clinic/Center | 17 Brooks Ave Unit1, Huntington, NY 11743 | 2017-03-29 |
| 1174983456 | Helene Falcone | Registered Nurse | 264 W. 22nd St., Oakwood Primary Center, Hunt., NY 11743 | 2016-03-01 |
| 1124499470 | Thomas Hlenski | Social Worker | 4 Richard Lane, Huntington, NY 11743 | 2015-10-13 |
| 1174921308 | Jeanne Ginsberg | Counselor | 81 Knollwood Avenue, Huntington, NY 11743 | 2014-12-22 |
| 1770980534 | Emily Ann Sombke | Physician Assistant | 249 Manor Rd., Huntington, NY 11743 | 2014-11-21 |
| 1881096162 | Applied Health Chiropractic | Chiropractor | 12 Ash Pl, Huntington, NY 11743 | 2014-09-18 |
| 1265857643 | Ccs Medical Practice, Pllc | Public Health or Welfare | 17 Southdown Road, Huntington, NY 11743 | 2014-02-21 |
| 1255760682 | Ekaterina Femminella | Acupuncturist | 181 Main St Ste 105, Huntington, NY 11743 | 2013-11-06 |
| Find all providers in zip 11743 | ||||
| Taxonomy Code | 364SP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862804 | Empire Np Psychiatric Care, Pllc | Clinical Nurse Specialist | 22 Nottingham Way, Cohoes, NY 12047-4972 | 2020-02-11 |
| 1710522875 | Upstate Ketamine Care | Clinical Nurse Specialist | 3300 Monroe Ave Ste 319, Rochester, NY 14618-4617 | 2019-11-13 |
| 1083840383 | Deborah Maxine Torres | Clinical Nurse Specialist | 184 Quaspeck Blvd, Valley Cottage, NY 10989-2428 | 2009-06-02 |
| 1306043203 | John Charles Azzopardi | Clinical Nurse Specialist | 220 E 87th St, Office Suite L.a., New York, NY 10128-3127 | 2007-07-02 |
| 1033268453 | Laura Kleinerman | Clinical Nurse Specialist | 156 West 86th Street, 1c, New York, NY 10024-4029 | 2007-01-09 |
| 1437250206 | Nancy C Seddio | Clinical Nurse Specialist | 39 Nippon Ave, Staten Island, NY 10312 | 2006-09-26 |
| 1295761070 | Beth A. Vandenberg | Clinical Nurse Specialist | 580 Pleasant View Dr, Lancaster, NY 14086-1404 | 2006-06-24 |
| 1457337404 | Lynn D Mitchell | Clinical Nurse Specialist | 629 W Main St, Riverhead, NY 11901-2842 | 2005-12-21 |
| 1124625074 | Danielle Damas | Clinical Nurse Specialist | 455 Tarrytown Rd Ste 1594, White Plains, NY 10607-1313 | 2020-10-05 |
| 1790303543 | Mary F Drost | Clinical Nurse Specialist | 155 Indian Head Rd, Commack, NY 11725-2212 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
| City | HUNTINGTON |
| Zip Code | 11743 |
Please comment or provide details below to improve the information on MS. MARTHA L KETTERIDGE.
| 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.