MELISSA ANTONOW (NPI# 1255837407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255837407 |
| Entity Type | Individual |
| Full Name | MELISSA ANTONOW |
| Practice Address |
6655 Fresh Pond Rd Ridgewood NY 11385-3261 |
| Mailing Address |
6141 69th Pl Middle Village NY 11379-1126 |
| Practice Telephone | 7184971919 |
| Mailing Telephone | 9179227005 |
| Mailing Fax Number | 9179227005 |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 631114 | NY | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
F3822794-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6655 FRESH POND RD |
| City | RIDGEWOOD |
| State | NY |
| Zip Code | 11385-3261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477530285 | Steven L Goodman | Orthopaedic Surgery | 6655 Fresh Pond Rd, Ridgewood, NY 11385 | 2005-12-22 |
| 1366097719 | Mingmar Doma Sherpa | Nurse Practitioner | 6655 Fresh Pond Rd, Ridgewood, NY 11385-3261 | 2019-08-02 |
| 1588107072 | Mario A Guerrero | Nurse Practitioner | 6655 Fresh Pond Rd, Ridgewood, NY 11385-3261 | 2016-12-01 |
| 1114469962 | Milana Chulpayev | Nurse Practitioner | 6655 Fresh Pond Rd, Ridgewood, NY 11385-3261 | 2016-11-10 |
| 1437599792 | Olga Slootsky | Nurse Practitioner | 6655 Fresh Pond Rd, Ridgewood, NY 11385-3261 | 2013-07-01 |
| 1255695276 | Danielle Vilsaint | Nurse Practitioner | 6655 Fresh Pond Rd, Ridgewood, NY 11385-3261 | 2012-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326650425 | Nicole Jablonska | Speech-Language Pathologist | 60-24 Grove Street, Ridgewood, NY 11385 | 2020-08-19 |
| 1295393296 | Ila Debra Christmas | Clinic/Center | 67-29 Myrtle Avenue, Glendale, NY 11385 | 2019-06-04 |
| 1164929584 | Carmen E. Vidal | Case Manager/Care Coordinator | 61-06 Metropolitan Ave., Ridgewood, NY 11385 | 2018-04-11 |
| 1467955385 | Avchemists LLC | Pharmacy | 68-28 Myrtle Ave, Glendale, NY 11385 | 2018-03-16 |
| 1235639667 | Yu-jen Hwang | Physical Therapist | 55-05 Myrtle Avenue, 2nd Floor, Ridgewood, NY 11385 | 2018-02-12 |
| 1477069185 | Selena Delgado | Behavior Technician | 64-07 Cooper Avenue, Glendale, NY 11385 | 2017-12-18 |
| 1851806913 | Myrtle Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 7933 Myrtle Ave, Flushing, NY 11385 | 2017-12-11 |
| 1104345727 | Suzanne Eng | Counselor | 1080 Wykoff Ave., Suite D4, Ridgewood, NY 11385 | 2017-09-14 |
| 1588183339 | Geri P Services Inc. | Early Intervention Provider Agency | 5938 Gates Ave, Ridgewood, NY 11385 | 2017-09-13 |
| 1922523935 | Kristen Michele Spang | Speech-Language Pathologist | 79-56 77th Road, Glendale, NY 11385 | 2017-08-10 |
| Find all providers in zip 11385 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063963437 | Susan Bell | Nurse Practitioner | 505 Goffle Rd, Ridgewood, NJ 07450-4027 | 2016-10-20 |
| 1255728853 | Kim Cahill | Nurse Practitioner | 505 Goffle Rd, Ridgewood, NJ 07450-4027 | 2015-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709821 | Shu-heng Wang | Nurse Practitioner | 7324 18th Ave, Brooklyn, NY 11204-5678 | 2020-10-29 |
| 1952909012 | Marina Byshovets | Nurse Practitioner | 164 Admiralty Loop, Staten Island, NY 10309-3964 | 2020-10-12 |
| 1700483799 | Dmitry Pediatrics, Pediatric Nurse Practitioner PC | Nurse Practitioner | 10 Shore Blvd Apt 1g, Brooklyn, NY 11235-4022 | 2020-10-03 |
| 1427664572 | Leigh Ann Cohen | Nurse Practitioner | 2 Lincoln Ave Ste 301, Rockville Centre, NY 11570-5775 | 2020-09-23 |
| 1295341436 | Tatiana Margaret Masone | Nurse Practitioner | 3142 Victory Blvd, Staten Island, NY 10314-6717 | 2020-09-22 |
| 1992311567 | Jyneva W Pickel | Nurse Practitioner | 3959 Broadway Rm 722, New York, NY 10032-1559 | 2020-09-19 |
| 1902410186 | Katie Elise Boyd | Nurse Practitioner | 725 Irving Ave Ste 504, Syracuse, NY 13210-1683 | 2020-09-03 |
| 1437763877 | Tiffany Yu | Nurse Practitioner | 1746 W 12th St, Brooklyn, NY 11223-1101 | 2020-09-02 |
| 1134733710 | Khristan Heagle Haller | Nurse Practitioner | 20 Locust Ln, Bronxville, NY 10708-4933 | 2020-09-01 |
| 1831703412 | Marijana Waite | Nurse Practitioner | 6544 Saunders St Apt A7, Rego Park, NY 11374-4209 | 2020-09-01 |
| Find all providers with the same taxonomy | ||||
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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.