IGOR LIZOGUBENKO (NPI# 1033163035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033163035 |
| Entity Type | Individual |
| Full Name | IGOR LIZOGUBENKO |
| Credential | P.A. |
| Practice Address |
200 Belle Terre Rd Port Jefferson NY 11777-1928 |
| Mailing Address |
Po Box 826207 Philadelphia PA 19182-6207 |
| Practice Telephone | 6314746000 |
| Mailing Telephone | 8003778721 |
| Mailing Fax Number | 3045232241 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2008-01-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 008125-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 BELLE TERRE RD |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777-1928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346243987 | Stacey Luise Tursi | Nurse Practitioner | 200 Belle Terre Rd, Dept. of Nursing Education, Port Jefferson, NY 11777 | 2005-05-27 |
| 1114555331 | Justine Morgan | Occupational Therapist | 200 Belle Terre Rd, Port Jefferson, NY 11777-1968 | 2020-04-01 |
| 1013543503 | Michelle Wah | Student in an Organized Health Care Education/Training Program | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2020-03-17 |
| 1285266130 | James Joseph Cassin | Student in an Organized Health Care Education/Training Program | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2020-02-09 |
| 1518599752 | Yigit Ali Gol | Student in an Organized Health Care Education/Training Program | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2020-02-05 |
| 1043855596 | Robert Kennedy Awadallah | Pharmacist | 200 Belle Terre Rd, Port Jefferson, NY 11777-1968 | 2019-11-07 |
| 1356983449 | Joseph Francis Byrne | Physician Assistant | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2019-10-10 |
| 1871149740 | Alyssa Dawn Morando | Dietitian, Registered | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2019-08-15 |
| 1912562133 | Cassandra Jones | Anesthesiology | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2019-05-02 |
| 1235697400 | Joshua Jihun Sok | Student in an Organized Health Care Education/Training Program | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2019-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| 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 |
|---|---|---|---|---|
| 1255806501 | Christopher Sorce | Physician Assistant | 635 Belle Terre Rd Ste 204, Port Jefferson, NY 11777-1977 | 2018-10-12 |
| 1699928846 | Palakkumar B Patel | Physician Assistant | 60 N Country Rd Ste 203, Port Jefferson, NY 11777-2188 | 2008-11-01 |
| 1013106715 | Christie Lee Cotty | Physician Assistant | 200 Belle Terre Rd #110, Port Jefferson, NY 11777 | 2007-10-18 |
| 1760529994 | John Joseph Woehrle | Physician Assistant | 645 Belle Terre Rd Apt 93, Port Jefferson, NY 11777-1944 | 2007-01-30 |
| 1124633169 | Ewelina Mieczkowska | Physician Assistant | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-09-15 |
| 1356983449 | Joseph Francis Byrne | Physician Assistant | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2019-10-10 |
| 1073080768 | Francis Richard Sicari | Physician Assistant | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2018-10-31 |
| 1477029585 | Diana Matari | Physician Assistant | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2018-10-16 |
| 1043792492 | Matthew Delph | Physician Assistant | 200 Belle Terre Rd, Port Jefferson, NY 11777-1928 | 2018-09-02 |
| 1588167456 | Giancarlo Garcia | Physician Assistant | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2018-03-16 |
| Find all providers in PORT JEFFERSON | ||||
| City | PORT JEFFERSON |
| Zip Code | 11777 |
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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.