JEAN HARRIS MANGOLD (NPI# 1275685216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275685216 |
Entity Type | Individual |
Full Name | JEAN HARRIS MANGOLD |
Credential | PNP |
Practice Address |
2225 Clinton Ave S Rochester NY 14618-2623 |
Mailing Address |
49 Pickford Dr Rochester NY 14618-4017 |
Practice Telephone | 5852562210 |
Mailing Telephone | 5854429802 |
Enumeration Date | 2007-01-18 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
F381281 | NY | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2225 CLINTON AVE S |
City | ROCHESTER |
State | NY |
Zip Code | 14618-2623 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518054485 | Metro Footcare Associates L.l.p. | Podiatrist | 2225 Clinton Ave S, Rochester, NY 14618-2623 | 2006-10-10 |
1740317056 | Penelope L Parris | Pediatrics | 2225 Clinton Ave S, Rochester, NY 14618-2664 | 2007-02-27 |
1942350350 | Elizabeth Supra | Pediatrics | 2225 Clinton Ave S, Rochester, NY 14618-2623 | 2007-01-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962056499 | Zahavi Dental of Rochester | Dentist | 1815 S. Clinton Ave, 510, Rocheter, NY 14618 | 2019-08-01 |
1760047278 | Inner Power Physical Therapy Pllc | Clinic/Center | 2561 Lac Deville Boulevard, Suite 100, Rochester, NY 14618 | 2019-05-09 |
1659859858 | Steven Sanfilippo | Counselor | 2000 S. Winton Rd., Building 4, Suite 303, Rochester, NY 14618 | 2018-07-31 |
1578064853 | Feet First Inc | Durable Medical Equipment & Medical Supplies | 1900 Clinton Ave S Ste 5, Rochester, NY 14618 | 2018-02-22 |
1558805374 | Jennifer Virella | Social Worker | 2000 South Winton Road, Bldg 2, Rochester, NY 14618 | 2016-12-13 |
1235589300 | Andrew Cyrus Marcy | Nurse Practitioner | 95 Allens Creek Road Bld 1 Ste 306, Rochester, NY 14618 | 2016-06-20 |
1932561073 | Legacy Pediatrics | Pediatrics | 1815 South Clinton Avenue Ste 360, Rochester, NY 14618 | 2016-03-28 |
1790143105 | Marie Lynn Bieber | Dietitian, Registered | 919 Winton Rd S Ste 220, Rochester, NY 14618 | 2016-02-01 |
1720443096 | Brittany Rose Masetta | Marriage & Family Therapist | 2000 S Winton Rd, Bldg 4, Suite #200, Rochester, NY 14618 | 2015-12-30 |
1437543097 | Kathleen Skye Kemp | Internal Medicine | 2400 S Clinton Ave Ste G2, Rochester, NY 14618 | 2015-03-22 |
Find all providers in zip 14618 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972126266 | Victoria Mack | Nurse Practitioner | 33 Landing Rd S, Rochester, NY 14610-3161 | 2020-05-21 |
1730749847 | Nicholas John Wodo | Nurse Practitioner | 601 Elmwood Ave Box 690, Rochester, NY 14642-0001 | 2019-06-20 |
1831438704 | Deborah Marie Tierney | Nurse Practitioner | 2200 Squirrel Road Human Health Building, Oakland University School of Nursing Room 2038, Rochester, MI 48309 | 2013-02-12 |
1205076122 | Panorama Pediatric Group, Rllp | Nurse Practitioner | 220 Linden Oaks Ste 200, Rochester, NY 14625-2839 | 2009-03-05 |
1932267721 | Amy Beth Realbuto | Nurse Practitioner | 451 E Henrietta Rd, 2nd Floor, Rochester, NY 14620-4629 | 2006-12-05 |
1396803169 | Melissa M Ryan | Nurse Practitioner | 601 Elmwood Ave Box 671, Rochester, NY 14642-0001 | 2006-12-05 |
1649345984 | Barbra Murante | Nurse Practitioner | 601 Elmwood Ave Rm 4-8123, Rochester, NY 14642-0001 | 2006-11-22 |
1730253808 | Paula Barbel | Nurse Practitioner | 451 E Henrietta Rd Fl 2, Rochester, NY 14620-4629 | 2006-11-20 |
1942372842 | Nancy Chevalier | Nurse Practitioner | 111 Westfall Road, Room 183, Rochester, NY 14692 | 2006-11-15 |
1215012521 | Patricia Ann Mccabe | Nurse Practitioner | 1850 Buffalo Rd, Suite 200 Genesis Pediatrics, Rochester, NY 14624-1502 | 2006-10-26 |
Find all providers in ROCHESTER |
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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.