DR. BRUCE SANDEROV (NPI# 1346254471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346254471 |
| Entity Type | Individual |
| Full Name | DR. BRUCE SANDEROV |
| Credential | MD |
| Practice Address |
519 W Jericho Tpke Smithtown NY 11787-2619 |
| Mailing Address |
519 W Jericho Tpke Suite 204 Smithtown NY 11787-2619 |
| Practice Telephone | 6313605900 |
| Practice Fax Number | 6313609403 |
| Mailing Telephone | 6313605900 |
| Mailing Fax Number | 6313609403 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2013-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
152464-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 1115475 | 05 |
| Street Address |
519 W JERICHO TPKE |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-2619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114970753 | Paolo Thomas Coppola | Emergency Medicine | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2006-05-17 |
| 1043713548 | City Medical of Upper East Side, Pllc | Clinic/Center | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2018-03-12 |
| 1396175170 | Stat Health Immediate Medical Care, PC | Clinic/Center | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2013-11-15 |
| 1316168321 | Stat Health Immediate Medical Care, PC | General Practice | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2007-05-01 |
| 1669514147 | Richard Scott Goldstein | Emergency Medicine | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2007-02-13 |
| 1104994912 | Marc Richard Salzberg | Emergency Medicine | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2006-12-01 |
| 1619067543 | Mary Jo Mcbride | Physician Assistant | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2006-10-13 |
| 1184646176 | Sarah Arzt | Emergency Medicine | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2006-07-25 |
| 1760413934 | Sandra Rose Picone | Emergency Medicine | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2006-07-06 |
| 1437187101 | Thomas Fischer | Emergency Medicine | 519 W Jericho Tpke, Smithtown, NY 11787-2619 | 2006-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
| Find all providers in zip 11787 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629143722 | Robbin Friedberg | Emergency Medicine | 50 Route 25a, Smithtown, NY 11787-1348 | 2006-11-22 |
| 1336212091 | Teresa Anderson | Emergency Medicine | 50 Route 25a, Smithtown, NY 11787-1348 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588129852 | Steve Lazo | Emergency Medicine | 3210 Greenpoint Ave, Long Island City, NY 11101-2010 | 2019-01-31 |
| 1730667734 | Lagrange Fire District | Emergency Medicine | 504 Freedom Plains Road, Poughkeepsie, NY 12603-2678 | 2018-08-01 |
| 1407217631 | Debonotropepamdpc | Emergency Medicine | 24 Charter Ave, Dix Hills, NY 11746-6447 | 2016-03-16 |
| 1699013946 | Medfirst Urgent Care | Emergency Medicine | 1751 Sheridan Dr, Tonawanda, NY 14223 | 2013-01-22 |
| 1356689855 | Medfirst Urgent Care, Pllc | Emergency Medicine | 3190 Niagara Falls Blvd, Amherst, NY 14228-1639 | 2013-01-18 |
| 1821341744 | Stat Medical Usa | Emergency Medicine | 1943 Vincent Ln, Syosset, NY 11791-9629 | 2012-10-16 |
| 1104132190 | Kildare Clarke | Emergency Medicine | 6 Hazelton Dr, White Plains, NY 10605-3805 | 2010-08-27 |
| 1659682219 | Mark Kenneth Ellis | Emergency Medicine | 2 5th Ave Apt 2d, New York, NY 10011-8832 | 2010-06-29 |
| 1497076806 | Jose Luis Romero | Emergency Medicine | 3636 Waldo Ave Apt 4n, Bronx, NY 10463-2256 | 2010-06-21 |
| 1619109121 | Matthew J. Krauthamer | Emergency Medicine | 16 Capri Ct, Dix Hills, NY 11746-6410 | 2009-08-17 |
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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.