DR. JACQUELINE SHALL-MCCUMISKEY (NPI# 1083160170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083160170 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE SHALL-MCCUMISKEY |
| Credential | PSY. D. |
| Practice Address |
1110 South Ave Suite 5 Staten Island NY 10314-3403 |
| Mailing Address |
20 Haven Esplanade St Staten Island NY 10301-2717 |
| Practice Telephone | 3472731290 |
| Mailing Telephone | 6464798068 |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
021797 | NY | Behavioral Health & Social Service Providers |
| Street Address |
1110 SOUTH AVE SUITE 5 |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609860121 | Michele Cammarata | Family Medicine | 1110 South Ave, Suite 306, Staten Island, NY 10314-3403 | 2005-09-12 |
| 1891315677 | Brooke Randall | Early Intervention Provider Agency | 1110 South Ave, Staten Island, NY 10314-3403 | 2020-04-21 |
| 1114551363 | Alyssa Elizabeth Ryan | Social Worker | 1110 South Ave, Staten Island, NY 10314-3403 | 2020-02-26 |
| 1548822372 | Nicole Vento | Case Manager/Care Coordinator | 1110 South Ave, Suite 405, Staten Island, NY 10314-3414 | 2019-07-02 |
| 1336707033 | Edyta Knobloch | Counselor | 1110 South Ave, Staten Island, NY 10314-3403 | 2019-05-29 |
| 1649760141 | Ashley Santucci | Occupational Therapist | 1110 South Ave, Staten Island, NY 10314-3403 | 2018-05-10 |
| 1558866103 | Jennifer Colon | Case Manager/Care Coordinator | 1110 South Ave, Staten Island, NY 10314-3403 | 2018-03-27 |
| 1740795467 | John Mccahey | Specialist | 1110 South Ave, Staten Island, NY 10314-3403 | 2017-12-04 |
| 1346601333 | Penrose Dermatology Pllc | Clinic/Center | 1110 South Ave, Suite 400, Staten Island, NY 10314-3403 | 2016-03-17 |
| 1790155372 | Laura Parisi | Counselor | 1110 South Ave, Suite 5, Staten Island, NY 10314-3403 | 2015-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003311218 | Valentina Teresa Diglio | Psychologist | 1110 South Ave Ste 5, Staten Island, NY 10314-3403 | 2018-03-28 |
| 1407205842 | Neil B Madero | Psychologist | 67 Jackson St, Staten Island, NY 10304-2229 | 2016-06-07 |
| 1306210125 | Ife Landsmark | Psychologist | New Broadview Manor - 70 Father Capodanno Blvd, Staten Island, NY 10305 | 2015-11-17 |
| 1639578206 | Pakier Psychological Services P.C. | Psychologist | 1550 Richmond Ave Ste 203, Staten Island, NY 10314-1578 | 2014-08-19 |
| 1649511783 | Virginia Boga | Psychologist | 979 Lamont Ave, Staten Island, NY 10309-2207 | 2013-03-14 |
| 1053695072 | Shveta Mittal | Psychologist | 180 Four Corners Rd, Staten Island, NY 10304-1222 | 2011-10-10 |
| 1841571312 | Susan Merle Tyburczy | Psychologist | 152 Ross Ave, Staten Island, NY 10306-2952 | 2011-08-29 |
| 1194022004 | Lauriann Mancini | Psychologist | 28 Brookside Loop, Staten Island, NY 10309-4501 | 2011-02-12 |
| 1578865523 | Frances Adele Melendez | Psychologist | 797 Brighton Ave, Staten Island, NY 10301-2736 | 2010-11-24 |
| 1780842922 | Linda Marconi-manda | Psychologist | 78 Cedarcliff Road, Staten Island, NY 10301-4402 | 2008-05-23 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on DR. JACQUELINE SHALL-MCCUMISKEY.
| 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.