CARL TACK (NPI# 1023189529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023189529 |
| Entity Type | Individual |
| Full Name | CARL TACK |
| Credential | MD |
| Practice Address |
Hsc L4 Rm 120 Stony Brook NY 11794-8460 |
| Mailing Address |
Hsc Level 4, Room 120 Stony Brook NY 11794-8460 |
| Practice Telephone | 6314445400 |
| Practice Fax Number | 6314447538 |
| Mailing Telephone | 6314445400 |
| Mailing Fax Number | 6314447538 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
157604 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01225323 | 05 |
| Street Address |
HSC L4 RM 120 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-8460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578552824 | Mary M Saltz | Radiology | Hsc L4 Rm 120, Stony Brook, NY 11794-8460 | 2005-10-19 |
| 1033351630 | Punit Chhaganlal Aghera | Radiology | Hsc L4 Rm 120, Stony Brook, NY 11794-8460 | 2009-03-27 |
| 1598960916 | Michael Jason Reiter | Radiology | Hsc L4 Rm 120, 100 Nichols Road, Stony Brook, NY 11794-8460 | 2007-06-16 |
| 1023118627 | Ajay Malhotra | Internal Medicine | Hsc L4 Rm 120, Stony Brook, NY 11794-8460 | 2006-09-23 |
| 1962504167 | Annapurneswara Rao Chimpiri | Radiology | Hsc L4 Rm 120, Stony Brook, NY 11794-8460 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023453495 | Daichi Hayashi | Radiology | Department of Radiology Stony Brook Medicine, Stony Brook, NY 11794 | 2013-04-30 |
| 1285994129 | Samantha Glass | Radiology | 101 Nichols Road, Department of Radiology, Stony Brook, NY 11794-7097 | 2012-05-25 |
| 1912266974 | Luboslav Woroch | Radiology | 100 Nichols Road, Hsc L4 Rm 120, Stony Brook, NY 11794-8460 | 2012-05-11 |
| 1720221369 | Lok Yun Sung | Radiology | 101 Nicolls Road, Department of Radiology, Hsc Level 4, Room 120, Stony Brook, NY 11794-8460 | 2009-04-13 |
| 1235378233 | Vladimir Sheynzon | Radiology | Stony Brook University Health Science Ctr, Department of Radiology, Hsc L4, Room 120, Stony Brook, NY 11794-0001 | 2009-02-13 |
| 1053579904 | Jennifer Faye Ripton-snyder | Radiology | Dept. of Radiology Stoney Brook Medicine, Hsc, Level 4, Room 120, Stony Brook, NY 11790 | 2008-05-28 |
| 1477730430 | Americo Saverio Fiore | Radiology | Hsc L4, Rm 120, Stony Brook, NY 11794-0001 | 2008-01-22 |
| 1447431796 | Hakan Sahin | Radiology | 101 Nicolls Rd Ste 120, Stony Brook, NY 11794-0001 | 2007-11-15 |
| 1023213725 | Mingqian Huang | Radiology | Nicolls Road and Health Sciences, Hsc Level 4 Room 120, Stony Brook, NY 11794-8460 | 2007-06-20 |
| 1235275496 | Dominic John Altieri | Radiology | 2500 Nesconset Hwy Bldg 15a, Stony Brook, NY 11790-2554 | 2007-01-29 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
Please comment or provide details below to improve the information on CARL TACK.
| 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.