MR. RUSSELL BROMING (NPI# 1154941425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154941425 |
| Entity Type | Individual |
| Full Name | MR. RUSSELL BROMING |
| Credential | P.A. |
| Practice Address |
259 1st St Mineola NY 11501-3957 |
| Mailing Address |
70 Cottonwood Ln Westbury NY 11590-5743 |
| Practice Telephone | 5166633366 |
| Mailing Telephone | 5169974447 |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 007191 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 70 Cottonwood Ln, Westbury, NY 115905743 | 5169974447 |
| Street Address |
259 1ST ST |
| City | MINEOLA |
| State | NY |
| Zip Code | 11501-3957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801892641 | Frederick James | Nurse Anesthetist, Certified Registered | 259 1st St, Mineola, NY 11501-3957 | 2005-06-27 |
| 1164039855 | James Jacob | Nurse Anesthetist, Certified Registered | 259 1st St, Mineola, NY 11501-3957 | 2020-09-26 |
| 1649887530 | Michael D'alto | Emergency Medicine | 259 1st St, Mineola, NY 11501-3957 | 2020-09-25 |
| 1174136121 | Anatoliy Mirkin | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-08-28 |
| 1497368823 | Sajumon K Joseph | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-08-25 |
| 1730707134 | Nathan Augustus Starkman | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-07-12 |
| 1164040143 | Melissa Dale Kersch | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-07-07 |
| 1518582964 | Jennifer Behbodikhah | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-06-11 |
| 1912521386 | Samuel Baskharoun | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-06-02 |
| 1346863404 | James Anthony Priftakis | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-05-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500350 | Steve Abraham Simon | Student in an Organized Health Care Education/Training Program | 222 Station Plaza, Suite 509, Mineola, NY 11501 | 2020-05-18 |
| 1407478167 | Frederick Milton Bosoy | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, Ny 11501, Mineola, NY 11501 | 2020-05-15 |
| 1982226130 | Katelyn Anne Fowler | Counselor | [email protected], 410 East Jericho Tpke, Mineola, NY 11501 | 2020-05-11 |
| 1225667819 | New York Dialysis Services, Inc | Clinic/Center | 1 East Jericho Turnpike, Mineola, NY 11501 | 2020-04-06 |
| 1518500032 | Irina Victoria Kushnareva | Social Worker | 126 Saville Rd, Mineola, NY 11501 | 2019-10-28 |
| 1861046336 | Milagros M Matias | Case Manager/Care Coordinator | 39 E. Jericho Turnpike, Mineola, NY 11501 | 2019-08-01 |
| 1154974244 | Bahram Dabiri | Student in an Organized Health Care Education/Training Program | 222 Station Plaza N., Suite 620 Mineola, Mineola, NY 11501 | 2019-07-18 |
| 1972168748 | Nabeel A. Arain | Physician Assistant | 251 1st St., Mineola, NY 11501 | 2019-05-07 |
| 1598328940 | Ramsha Jabbar | Student in an Organized Health Care Education/Training Program | 222 Station Plaza North, Suite 305, Mineola, NY 11501 | 2019-04-20 |
| 1235628850 | Valentyna Erstenyuk | Student in an Organized Health Care Education/Training Program | 222 Station Plaza N, Suite 611, Mineola, NY 11501 | 2018-05-09 |
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| 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 |
|---|---|---|---|---|
| 1972168748 | Nabeel A. Arain | Physician Assistant | 251 1st St., Mineola, NY 11501 | 2019-05-07 |
| 1609394436 | Jaime Lynn Moyles | Physician Assistant | 200 Old Country Rd Ste 365, Mineola, NY 11501-4240 | 2017-08-31 |
| 1215191580 | Sreedhar P. Sudnagunta | Physician Assistant | 80 E Jericho Tpke, Suite 100, Mineola, NY 11501-3140 | 2008-07-15 |
| 1881865533 | Abo Suyonov | Physician Assistant | 700 Hickville Road, 259 1st Street, Mineola, NY 11501 | 2008-03-20 |
| 1720268097 | Anjli Kakwani | Physician Assistant | Northwell Gohealth Urgent Care, 50 East Jericho Turnpike, Mineola, NY 11501 | 2007-11-05 |
| 1144419292 | Iosif Galibov | Physician Assistant | 222 Station Plz N Ste 428, Mineola, NY 11501-3819 | 2007-10-15 |
| 1194883066 | Shannon Marie Dipaola | Physician Assistant | 259 First St, Mineola, NY 11501-3957 | 2006-12-04 |
| 1003841560 | Tony Phillips | Physician Assistant | 312 N Pacific St, Mineola, TX 75773-1712 | 2006-07-12 |
| 1700436136 | Stacey Krasnoff | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2019-09-17 |
| 1750931499 | Alexandra Sanfilippo | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2019-09-15 |
| Find all providers in MINEOLA | ||||
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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.