ELISHIA KATHLEEN CRUMWELL-MACK (NPI# 1144863051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144863051 |
| Entity Type | Individual |
| Full Name | ELISHIA KATHLEEN CRUMWELL-MACK |
| Practice Address |
400 Community Dr Manhasset NY 11030-3815 |
| Mailing Address |
17755 Meadow Dr # 2 Jamaica NY 11434-4945 |
| Practice Telephone | 5165624664 |
| Practice Fax Number | 5165622683 |
| Mailing Telephone | 2128580271 |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2019-10-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
F309111-1 | NY | Allopathic & Osteopathic Physicians |
| N | 207RT0003X |
Internal Medicine Specialization: Transplant Hepatology |
F309111-1 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
400 COMMUNITY DR |
| City | MANHASSET |
| State | NY |
| Zip Code | 11030-3815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255311403 | Halana Rothbort | Psychiatry & Neurology | 400 Community Dr, Manhasset, NY 11030-3815 | 2006-01-21 |
| 1457974107 | Diana Elena Dalmasi | Family Medicine | 400 Community Dr, Manhasset, NY 11030-3815 | 2020-05-28 |
| 1871137646 | Jinu Mathew Thomas | Nurse Practitioner | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-11-04 |
| 1477102234 | Lawrence Lau | Transplant Surgery | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-09-05 |
| 1619520376 | Cassandra L Jonaitis | Nurse Practitioner | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-07-22 |
| 1932751757 | Danielle Lauren Cabral | Pharmacist | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-07-11 |
| 1629542691 | Julie Lauren Pennetti | Nurse Practitioner | 400 Community Dr, Manhasset, NY 11030-3815 | 2019-01-14 |
| 1568949600 | Michelle H Min | Pharmacist | 400 Community Dr, Manhasset, NY 11030 | 2018-07-22 |
| 1194246710 | Gabrielle Nicole Plaia | Pharmacist | 400 Community Dr, Manhasset, NY 11030-3815 | 2017-07-05 |
| 1669913133 | Diego Acero | Registered Nurse | 400 Community Dr, Manhasset, NY 11030-3815 | 2017-03-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754126 | Diana Fox | Registered Nurse | 330 Community Drive, Manhasset, NY 11030 | 2019-05-02 |
| 1215470257 | Melissa Fackler | Registered Nurse | 1350 Northern Blvd Ste 202, Manhasset, NY 11030 | 2016-11-23 |
| 1821443391 | Sarah Javdan | Family Medicine | 800 Community Dr Ste 206, Manhasset, NY 11030 | 2016-05-03 |
| 1891167458 | Stacie Thaw Lcsw Pllc | Social Worker | 115 Park Ave., Manhasset, NY 11030 | 2015-10-22 |
| 1538547971 | Aarti Kumar | Podiatrist | 535 Plandome Rd # 2, Manhasset, NY 11030 | 2015-05-18 |
| 1073933586 | Rachel Durante | Occupational Therapist | 600 Community Drive, Manhasset, NY 11030 | 2014-04-23 |
| 1831436435 | Anesthesia Care, P.C. | General Practice | 565 Plandome Road, Manhasset, NY 11030 | 2013-01-16 |
| 1821350091 | Sylvia Yoonsun Kim | Pharmacist | 139 Vanderbilt Ave, Manhasset, NY 11030 | 2012-06-13 |
| 1699062588 | Rod Stern | Dentist | 444 Community Dr Ste 201, Manhasset, NY 11030 | 2011-06-30 |
| 1558654798 | Alexandria Pace Kress | Speech-Language Pathologist | 31 Circle Dr, Manhasset, NY 11030 | 2011-05-20 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770752594 | Katherine S Freeman | Internal Medicine | 1155 Northern Blvd Ste 300, Manhasset, NY 11030-3041 | 2008-02-26 |
| 1790845840 | Bethany Devito | Internal Medicine | Nsuh Dept. of Medicine Gastroenterology, 300 Community Drive, Manhasset, NY 11030 | 2006-12-11 |
| 1063572113 | Bernard Stark | Internal Medicine | Nsuh Dept of Medicine Division of Gastroenterology, 300 Community Drive, Manhasset, NY 11030 | 2006-12-11 |
| 1912078304 | David Bernstein | Internal Medicine | Nsuh-dept of Med Div of Gastro, 300 Community Drive, Manhasset, NY 11030 | 2006-11-10 |
| 1124198569 | Edna Khodadadian | Internal Medicine | Nsuh - Dept of Medicine, 300 Community Drive, Manhasset, NY 11030 | 2006-11-09 |
| 1174866040 | Ben Lin Da | Internal Medicine | 400 Community Dr, Manhasset, NY 11030-3815 | 2013-03-29 |
| 1376824516 | Christian Kuntzen | Internal Medicine | 400 Community Dr, Manhasset, NY 11030-3815 | 2011-09-01 |
| 1457676090 | Chun Kit Hung | Internal Medicine | 300 Community Dr, Manhasset, NY 11030-3816 | 2010-04-06 |
| 1386873487 | Great Neck Gastro, Pllc | Internal Medicine | 1155 Northern Blvd, Suite 360, Manhasset, NY 11030-3040 | 2009-07-09 |
| 1285886416 | Betsy Ann Pathickal | Internal Medicine | 300 Community Dr, Manhasset, NY 11030-3816 | 2008-10-21 |
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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.