LUCIO MALACO PEREIRA (NPI# 1134336597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134336597 |
Entity Type | Individual |
Full Name | LUCIO MALACO PEREIRA |
Credential | M.D. |
Practice Address |
430 Lakeville Rd New Hyde Park NY 11042-1121 |
Mailing Address |
5419 Linden Ct Bethesda MD 20814-1643 |
Practice Telephone | 7184707550 |
Mailing Telephone | 3139097782 |
Enumeration Date | 2007-05-16 |
Last Update Date | 2017-02-06 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Y00000X | Otolaryngology | 287411-1 | NY | Allopathic & Osteopathic Physicians |
Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
287411-1 | NY | Allopathic & Osteopathic Physicians |
Street Address |
430 LAKEVILLE RD |
City | NEW HYDE PARK |
State | NY |
Zip Code | 11042-1121 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851465991 | Edward C Gabalski | Otolaryngology | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2006-11-20 |
1124634365 | Jenni Wu | Speech-Language Pathologist | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2020-09-22 |
1679194724 | Angela Benetti | Speech-Language Pathologist | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2020-04-29 |
1215572375 | Martha Alexandra Tatis | Nurse Practitioner | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2019-11-13 |
1972062164 | Michelle Soloff | Student in an Organized Health Care Education/Training Program | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2019-03-18 |
1992279137 | Nicole Marie Pirretti | Speech-Language Pathologist | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2019-01-21 |
1093284093 | Elizabeth Alencherry | Nurse Practitioner | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2018-11-19 |
1881122646 | Sheilah Rose Power | Speech-Language Pathologist | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2017-05-24 |
1386003861 | Long Island Jewish Medical Center - Hearing and Speech Center | Audiologist | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2016-02-12 |
1932574415 | Catherine Anne O'connor | Audiologist | 430 Lakeville Rd, New Hyde Park, NY 11042-1121 | 2015-12-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649871260 | Advanced Cardiovascular Diagnostics, Pllc | Internal Medicine | 410 Lakeville Road Suite 209, New Hyde Park, NY 11042 | 2020-11-02 |
1568093771 | Global Slp Ot Pt & Psychological Services, Pllc | Physical Therapist | 1979 Marcus Avenue - Suite 204, Attn: Jon Polish, Lake Success, NY 11042 | 2020-01-28 |
1730745761 | Miriam Korbman | Psychologist | 2001 Marcus Ave Suite E128, Lake Success, NY 11042 | 2019-05-15 |
1306402409 | Swachi Jain | Student in an Organized Health Care Education/Training Program | Northwell Health Pathology, 6 - Ohio Drive, Suite 202, Lake Success, NY 11042 | 2019-05-14 |
1215407432 | Samara Carly Badash | Physical Therapist | Brookville Center for Children's Services, 1983 Marcus Avenue, Suite E100, New Hyde Park, NY 11042 | 2018-11-30 |
1720578578 | Nidhi Kataria | Student in an Organized Health Care Education/Training Program | Department of Pathology and Laboratory Medicine, Northw, 6 Ohio Drive, Suite 202, Lake Success, NY 11042 | 2018-05-17 |
1558870162 | Rosemary Elizabeth Fine | Nurse Practitioner | 1999 Marcus Ave Ste 306, New Hyde Park, NY 11042 | 2017-09-26 |
1255861159 | Nicole Renee Cohen | Speech-Language Pathologist | 1893 Marcus Ave, C118, New Hyde Park, NY 11042 | 2017-06-14 |
1366807943 | Molly Rubinoff | Nurse Practitioner | 1215 One Hollow Lane, #301, New Hyde Park, NY 11042 | 2015-12-23 |
1255701959 | Prohealth Dental Pllc | Dentist | 1 Pro Health Plz, Suite 115, New Hyde Park, NY 11042 | 2015-10-07 |
Find all providers in zip 11042 |
Taxonomy Code | 207YX0007X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
Specialization | Plastic Surgery within the Head & Neck |
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245524370 | Jason Brian Wasserman | Otolaryngology | 210 - 33 26th Ave, Ground Level, Bayside, NY 11360-1949 | 2011-06-06 |
1841591765 | Jack Martin Shapiro | Otolaryngology | 147 Bacon Rd, Old Westbury, NY 11568 | 2010-11-09 |
1831341643 | Krishnakumar Thankappan | Otolaryngology | Dept of Head and Neck Roswell Park Cancer, Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2008-10-13 |
1235292855 | George J Braun | Otolaryngology | 38 E 38th St, New York, NY 10016-2505 | 2006-12-18 |
1811942220 | Oleh Slupchynskyj | Otolaryngology | 44 E 65th St, 1a, New York, NY 10021-7022 | 2006-05-23 |
1346629110 | Steven Andrew Gordon | Otolaryngology | 550 First Ave, Nyu Langone Medical Center, New York, NY 10016 | 2015-05-26 |
1043698608 | Nyc Metro Ent PC | Otolaryngology | 6273 Woodhaven Blvd, Rego Park, NY 11374-2832 | 2015-05-14 |
1396163747 | Ashley Paige O'connell Ferster | Otolaryngology | 2365 S Clinton Ave Ste 200, Rochester, NY 14618-2663 | 2014-04-02 |
1275824856 | Eric William Cerrati | Otolaryngology | 550 First Avenue, Nyu Langone Medical Center, New York, NY 10016 | 2011-04-29 |
1184858458 | Paul Raymond Young | Otolaryngology | 4955 N Bailey Ave, Suite 202, Amherst, NY 14226-1206 | 2009-05-14 |
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City | NEW HYDE PARK |
Zip Code | 11042 |
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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.