KRISTINA THERESA DIMEZZA (NPI# 1306210216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306210216 |
| Entity Type | Individual |
| Full Name | KRISTINA THERESA DIMEZZA |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
60 Merrick Ave East Meadow NY 11554 |
| Mailing Address |
139 S 1st St Lindenhurst NY 11757-4916 |
| Practice Telephone | 6313742479 |
| Mailing Telephone | 6313742479 |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2019-01-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
019235 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 04354629 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Titan Medical Group, 44 Cutter Lane, Levittown, NY 11756 | 5162244157 |
| Street Address |
60 MERRICK AVE |
| City | EAST MEADOW |
| State | NY |
| Zip Code | 11554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326037474 | Olaf Butchma | Internal Medicine | 60 Merrick Ave, East Meadow, NY 11554-1578 | 2005-10-20 |
| 1508369265 | Kulbhushan Himmat Dhamane | Physical Therapist | 60 Merrick Ave, East Meadow, NY 11554-1578 | 2018-03-08 |
| 1073684726 | Igor Gutnik | Internal Medicine | 60 Merrick Ave, East Meadow, NY 11554-1578 | 2006-11-13 |
| 1891718490 | Anthony C Kim | Internal Medicine | 60 Merrick Ave, East Meadow, NY 11554-1578 | 2006-07-25 |
| 1225029234 | Fulton Commons Care Center, Inc. | Skilled Nursing Facility | 60 Merrick Ave, East Meadow, NY 11554-1578 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164033254 | Ellen B. Gordon | Counselor | 533 Wagstaff Drive, East Meadow, NY 11554 | 2020-08-12 |
| 1770140717 | Saad Wasiq | Student in an Organized Health Care Education/Training Program | Psychiatry Department, Nassau University Medicial Centre, East Meadow, NY 11554 | 2019-05-24 |
| 1407410202 | Shiana Sekhri | Student in an Organized Health Care Education/Training Program | Nassau Univ Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554 | 2019-04-26 |
| 1427612738 | Shanli Parnia | Student in an Organized Health Care Education/Training Program | Nuhealth/nassau University Medical Center - 2201 Hempst, East Meadow, NY 11554 | 2019-04-23 |
| 1003308842 | Sindhu Barola | Student in an Organized Health Care Education/Training Program | 2201 Hempstead Turnpike Nassau University Medical Cente, Department of Pediatrics, East Meadow, NY 11554 | 2018-06-06 |
| 1831681121 | Sehajvir Singh Madhok | Student in an Organized Health Care Education/Training Program | 2201 Hempstead Turnpike Nassau University Medical Centr, Department of Pediatrics, East Meadow, NY 11554 | 2018-06-01 |
| 1184115917 | Neeti Prerana Luke | Student in an Organized Health Care Education/Training Program | Nassau University Medical Centre, 2201 Hempstead Turnpike, East Meadow, NY 11554 | 2018-05-29 |
| 1992292155 | Syed Mudassir Hussaini | Student in an Organized Health Care Education/Training Program | Nassau University Medical Center Deparetment of Medicin, 2201 Hempstead Turnpike, East Meadow, NY 11554 | 2018-04-13 |
| 1942726724 | Renju Thomas | Nurse Practitioner | 1901 North Jerusalem Rd, Eastmeadow, NY 11554 | 2017-08-14 |
| 1871013185 | Michelle Kates | Specialist | 1491 Rose Lane, East Meadow, NY 11554 | 2017-06-27 |
| Find all providers in zip 11554 | ||||
| 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 |
|---|---|---|---|---|
| 1972115665 | Leyon Balgobind | Physician Assistant | 503 Lakeville Ln, East Meadow, NY 11554-2201 | 2020-08-23 |
| 1275185902 | Faiza Javed | Physician Assistant | 127 Barbara Dr, East Meadow, NY 11554-1110 | 2019-07-12 |
| 1013363704 | Eric M Smith | Physician Assistant | 2251 Hempstead Tpke Bldg R, East Meadow, NY 11554-1856 | 2016-05-11 |
| 1285062380 | Christina Varughese | Physician Assistant | 1826 Prospect Ave, East Meadow, NY 11554-3036 | 2013-10-29 |
| 1992139679 | Jovana Dias | Physician Assistant | 1919 Union Turkpike, East Meadow, NY 11554 | 2013-08-29 |
| 1154612505 | Jooneui Kwon | Physician Assistant | 2201 Heampstead Tpke, East Meadow, NY 11554 | 2011-04-20 |
| 1639320724 | Daniel Joseph Bannen Jr. | Physician Assistant | 2589 Ramona St, East Meadow, NY 11554-5319 | 2008-10-07 |
| 1285231050 | Emily Ann Paruch | Physician Assistant | 2310 Hempstead Tpke, East Meadow, NY 11554-2035 | 2020-10-05 |
| 1396365367 | Anthony John Corcoran | Physician Assistant | 2310 Hempstead Tpke, East Meadow, NY 11554-2035 | 2020-04-20 |
| 1215578042 | Andrea Esperanza Bisono | Physician Assistant | 2201 Hempstead Tpke, East Meadow, NY 11554-1859 | 2019-10-02 |
| Find all providers in EAST MEADOW | ||||
| City | EAST MEADOW |
| Zip Code | 11554 |
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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.