DIMPLE PUTHETHUKUDI GEORGE (NPI# 1194100537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194100537 |
| Entity Type | Individual |
| Full Name | DIMPLE PUTHETHUKUDI GEORGE |
| Credential | N P |
| Practice Address |
101 Hospital Road Brook Haven Hospital Medical Center Patchogue NY 11772 |
| Mailing Address |
70 Dare Rd Selden NY 11784-2004 |
| Practice Telephone | 6316547214 |
| Mailing Telephone | 6314281645 |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F307244 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
101 HOSPITAL ROAD BROOK HAVEN HOSPITAL MEDICAL CENTER |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639121825 | Brookhaven Memorial Hospital Medical Center | Emergency Medicine | 101 Hospital Road, Patchogue, NY 11772-4870 | 2006-05-16 |
| 1225584204 | Michael Kirk | Student in an Organized Health Care Education/Training Program | 101 Hospital Road, Patchogue, NY 11772 | 2016-08-30 |
| 1417232760 | Brookhaven Memorial Hospital Medical Center, Inc. | Internal Medicine | 101 Hospital Road, Patchogue, NY 11772-4870 | 2011-10-19 |
| 1073824454 | Felix James Grucci IIi | Neuromusculoskeletal Medicine & OMM | 101 Hospital Road, Access Center, Patchogue, NY 11772-4870 | 2010-06-30 |
| 1346429115 | Brookhaven Memorial Hospital Medical Center | Psychiatry & Neurology | 101 Hospital Road, Patchogue, NY 11772-4870 | 2007-10-30 |
| 1487843090 | Brookhaven Memorial Hospital Medical Center, Inc. | Physician Assistant | 101 Hospital Road, Patchogue, NY 11772-4870 | 2007-10-19 |
| 1528133147 | Brookhaven Memorial Hospital Medical Center, Inc. | Psychiatric Unit | 101 Hospital Road, Patchogue, NY 11772-4870 | 2006-11-21 |
| 1235210931 | Brookhaven Memorial Hospital Medical Center | Clinic/Center | 101 Hospital Road, Patchogue, NY 11772-4870 | 2006-10-18 |
| 1114014065 | Brookhaven Memorial Hospital Medical Center | Radiology | 101 Hospital Road, Patchogue, NY 11772 | 2006-10-10 |
| 1356375083 | Diane Rosario | Physician Assistant | 101 Hospital Road, Brookhaven Memorial Hospital, Patchogue, NY 11772 | 2006-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447224 | Amita Vipul Patel | Nurse Practitioner | Longlsland Community Hospital, 101 Hospital Rd, Patchogue, NY 11772 | 2020-08-13 |
| 1609491968 | Sanjib Dey | Family Medicine | Brookhaven Nephrology Associates, 260 E. Patchogue-yaphank Rd., Patchogue, NY 11772 | 2020-06-12 |
| 1992297204 | Camila Bueno-sanchez | Student in an Organized Health Care Education/Training Program | 676 S Country Rd, East Patchogue, NY 11772 | 2018-06-01 |
| 1184115859 | Premier Endodontics of Patchogue | Dentist | 44 Medford Avenue, Patchogue, NY 11772 | 2018-05-29 |
| 1801386453 | Franklin Ikechukwu Ugbode | Student in an Organized Health Care Education/Training Program | 100 Hospital Road Suite 201, Patchogue, NY 11772 | 2018-05-18 |
| 1508372335 | Stephanie Vanschaick | Counselor | 450 Waverly Ave Ste 11, Patchogue, NY 11772 | 2017-12-15 |
| 1578074498 | Chrystal Lee Curran | Specialist | 1116 Main Road, Aquebogue, NY 11772 | 2017-10-18 |
| 1013457712 | Candyce Fahner | Registered Nurse | 22 Haig Ave, E Patchogue, NY 11772 | 2017-02-28 |
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| Find all providers in zip 11772 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| 1629491402 | Christina Marie Dalrymple | Nurse Practitioner | 325 E Main St Ste 120, Patchogue, NY 11772-3114 | 2014-01-29 |
| 1942447347 | Natalie S Synnott | Nurse Practitioner | 4 Phyllis Dr Ste C, Patchogue, NY 11772-2900 | 2009-01-07 |
| 1427276914 | Christine M Aiello | Nurse Practitioner | 629 Medford Ave, Suite #1, Patchogue, NY 11772-1335 | 2007-04-23 |
| 1003987637 | Linda Belber | Nurse Practitioner | 68 Washington Ave, Patchogue, NY 11772-2953 | 2006-11-13 |
| 1518512581 | Wendy Doroski | Nurse Practitioner | 77 Medford Ave, Patchogue, NY 11772-1281 | 2019-08-07 |
| 1205489119 | Diane Cesario | Nurse Practitioner | 325 E Main St, Patchogue, NY 11772-3114 | 2019-07-19 |
| 1730604752 | Daniel Thomas Ippolito | Nurse Practitioner | 77 Medford Ave, Patchogue, NY 11772-1281 | 2017-08-10 |
| 1184162620 | Sheryll Baltazar | Nurse Practitioner | 157 E Woodside Ave, Patchogue, NY 11772-1423 | 2017-02-04 |
| Find all providers in PATCHOGUE | ||||
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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.