DR. NICOLE PETZOLT (NPI# 1063836500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063836500 |
| Entity Type | Individual |
| Full Name | DR. NICOLE PETZOLT |
| Credential | PSY.D. |
| Practice Address |
300 Garden City Plz Suite 400 Garden City NY 11530-3302 |
| Practice Telephone | 5162480006 |
| Mailing Telephone | 5162480006 |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-04-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 020428-1 | NY | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
020428-1 | NY | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
020428-1 | NY | Behavioral Health & Social Service Providers |
| Street Address |
300 GARDEN CITY PLZ SUITE 400 |
| City | GARDEN CITY |
| State | NY |
| Zip Code | 11530-3302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073547147 | Jeffrey R Desarbo | Psychiatry & Neurology | 300 Garden City Plz, Garden City, NY 11530-3302 | 2006-07-11 |
| 1861008369 | Adrienne Kelly | Specialist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-09-20 |
| 1396359444 | Kristin Summers Gallucci | Occupational Therapist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-09-06 |
| 1497369771 | Thomas Vincent Whalen | Physical Therapist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-09-03 |
| 1326651423 | Lauren Sustad | Specialist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-08-28 |
| 1407469083 | Daniella Latino | Speech-Language Pathologist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-08-25 |
| 1699387720 | Nicole M. Mcnair | Counselor | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-08-19 |
| 1083222103 | Suzanne Levy | Counselor | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-07-14 |
| 1831707082 | Joanna Nicole Marullo | Case Manager/Care Coordinator | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-07-14 |
| 1285255331 | Darienne Bergman | Psychologist | 300 Garden City Plz, Garden City, NY 11530-3302 | 2020-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144850207 | Ellen Jay Palacio Mabatid | Physical Therapist | 66 New Hyde Park, Garden City, NY 11530 | 2020-01-16 |
| 1255991022 | Rubin Anesthesia Pain Management, Pllc | Anesthesiology | 1103 Stewart Avenue, Suite 300, Garden City, NY 11530 | 2019-06-14 |
| 1144793720 | Jack Doby Garden City, LLC | Eyewear Supplier (Equipment, not the service) | Jack Doby Garden City, LLC, 928 Old Country Road, Garden City, NY 11530 | 2019-01-07 |
| 1386135051 | Granger & Sahasra | Dentist | 1103 Stewart Avenue Suite 104, Garden City, NY 11530 | 2018-05-29 |
| 1598262537 | Suzanne P. Reid-bradshaw | Specialist | Kidz Therapy, 300 Garden City Plaza, Garden City, NY 11530 | 2018-04-06 |
| 1972021129 | Nicole Maria Gaudino | Nurse Practitioner | One South Avenue, Waldo Hall, Garden City, NY 11530 | 2017-09-07 |
| 1619495645 | Christine Scheppa | Registered Nurse | 225 Brompton Rd South, Garden City South, NY 11530 | 2017-08-30 |
| 1699290981 | Deborah Ann Pontosky | Registered Nurse | 104 Fifth Street, Garden City, NY 11530 | 2017-08-08 |
| 1932648748 | Tahmina Jahir | Student in an Organized Health Care Education/Training Program | 15 Hilton Ave, Garden City, NY 11530 | 2017-02-14 |
| 1598209173 | Dino Michelli | Specialist | 300 Garden City Plaza, Ste 350, Kidz Therapy/ Gayle E. Kligman Therapeutic Resources, Garden City, NY 11530 | 2016-12-15 |
| Find all providers in zip 11530 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932651288 | Kathleen Acer | Psychologist | 218 Nassau Blvd, Garden City, NY 11530-1234 | 2016-11-02 |
| 1043767809 | Gabriella Harrison | Psychologist | 601 Franklin Ave Ste 120, Garden City, NY 11530-5760 | 2016-09-08 |
| 1306268602 | Jairo Fuertes | Psychologist | 158 Cambridge Ave, Rm 319, Garden City, NY 11530-4235 | 2014-01-06 |
| 1841577004 | Mark S. Closson | Psychologist | 601 Franklin Ave Ste 200, Garden City, NY 11530-5760 | 2011-11-15 |
| 1174841027 | Thomas W. Hoffman | Psychologist | 109 Wyatt Rd, Garden City, NY 11530-3117 | 2010-05-16 |
| 1487887832 | Maureen Flynn Welsh | Psychologist | 126 Whitehall B Lvd, Garden City, Garden City, NY 11530 | 2009-09-02 |
| 1144410838 | Anthony John Decamello | Psychologist | 232 Brixton Rd S, Garden City, NY 11530-5627 | 2007-07-28 |
| 1891993549 | Susan E Repetto | Psychologist | 233 7th St Ste 300, Garden City, NY 11530-5747 | 2007-07-04 |
| 1093835282 | Robert William Motta | Psychologist | 233 Seventh Street, Suite #12, Garden City, NY 11530 | 2007-03-30 |
| 1740347970 | Eva L. Feindler | Psychologist | 8 Prospect Ave, Garden City, NY 11530-6354 | 2007-01-03 |
| Find all providers in GARDEN CITY | ||||
| City | GARDEN CITY |
| Zip Code | 11530 |
Please comment or provide details below to improve the information on DR. NICOLE PETZOLT.
| 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.