JOSE DARIO OVALLE (NPI# 1013124627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013124627 |
| Entity Type | Individual |
| Full Name | JOSE DARIO OVALLE |
| Credential | PA |
| Practice Address |
102 11 Roosevelt Ave. Corona NY 11368-2331 |
| Mailing Address |
102 -11 Roosevelt Ave. Corona NY 11368-2331 |
| Practice Telephone | 7178985200 |
| Practice Fax Number | 7188983673 |
| Mailing Telephone | 7189895200 |
| Mailing Fax Number | 7188983673 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 009185 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02830239 | 05 |
| Street Address |
102 11 ROOSEVELT AVE. |
| City | CORONA |
| State | NY |
| Zip Code | 11368-2331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770799215 | Maria Quezada | Pediatrics | 102 11 Roosevelt Ave., Corona, NY 11368-2331 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760014039 | Marukh Naeem | Behavioral Analyst | 11119a Roosevelt Ave, Apt 2r, Apt 2r, Corona, NY 11368 | 2020-02-05 |
| 1164072989 | Tonyia Michelle Madison | Counselor | 34-10 108 Street, Corona, Queens, NY 11368 | 2019-09-13 |
| 1962987347 | Sinead Anel Ulloa | Speech-Language Pathologist | 10420 37th Rd, Corona, NY 11368 | 2018-10-01 |
| 1245725779 | Bracha Namdar | Optometrist | 103-06 Roosevelt Ave, Corona, NY 11368 | 2018-06-27 |
| 1548758220 | Karina Elizabeth Carrasco | Specialist | 96- 32 46th Ave, Corona, NY 11368 | 2018-04-27 |
| 1134634033 | Nicole Iuculano | Speech-Language Pathologist | 43-18 97th Place, Corona, NY 11368 | 2017-12-13 |
| 1558880831 | Abenaa Nyame Danquah | Registered Nurse | 55-25 98th Place, Apt 1k, Corona, NY 11368 | 2017-09-18 |
| 1063940443 | Brand Rx Pharmacy Corp | Pharmacy | 97-05 A 57th Avenue, Corona, NY 11368 | 2017-05-30 |
| 1427595909 | Richelle Krish Sumaoy Colmenares | Physical Therapist | 3744 104th St., Corona, New York City, NY 11368 | 2017-01-23 |
| 1235674342 | 39th Avenue Physical Therapy PC | Clinic/Center | 103-18c 39 Ave, Corona, NY 11368 | 2016-12-28 |
| Find all providers in zip 11368 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830181 | Lauren Bennett | Physician Assistant | 3360 Horizon St, Corona, CA 92881-0728 | 2020-10-29 |
| 1710520671 | Diba Izadyar | Physician Assistant | 4617 Temescal Canyon Rd Apt 208, Corona, CA 92883-4680 | 2019-10-23 |
| 1619534856 | Michael Christopher Charvis | Physician Assistant | 10411 Baldy Ct, Corona, CA 92883-9260 | 2019-05-23 |
| 1053882076 | Michael Eng | Physician Assistant | 760 Washburn Ave Ste 5, Corona, CA 92882-3303 | 2018-12-17 |
| 1740761154 | Rachael Renee Fulton | Physician Assistant | 651 Birchwood Ln, Corona, CA 92882-6127 | 2018-08-23 |
| 1972095693 | Eva Day | Physician Assistant | 1727 Gleason St, Corona, CA 92882-5634 | 2018-05-30 |
| 1477060499 | Shilpy Kanda | Physician Assistant | 2250 S Main St Ste 107, Corona, CA 92882 | 2017-12-29 |
| 1588090948 | Aprilyn Nadine Carl | Physician Assistant | 758 Highland View Dr, Corona, CA 92882-8679 | 2013-09-17 |
| 1003156449 | Ruoru Wong | Physician Assistant | 3717 111th St Apt 5e, Corona, NY 11368-2018 | 2013-02-21 |
| 1669718383 | Bushrah Patel | Physician Assistant | 915 Rimpau Ave, Apt 101, Corona, CA 92879-2354 | 2012-12-28 |
| Find all providers in CORONA | ||||
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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.