MARK-MINA M ISHAK (NPI# 1356682652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356682652 |
| Entity Type | Individual |
| Full Name | MARK-MINA M ISHAK |
| Credential | D.O. |
| Practice Address |
2500 Nesconset Highway Building 18c Stony Brook NY 11790 |
| Practice Telephone | 6317512700 |
| Practice Fax Number | 6317515853 |
| Mailing Telephone | 6317512700 |
| Mailing Fax Number | 6317515853 |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2019-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 296442 | NY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2500 NESCONSET HIGHWAY BUILDING 18C |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508306333 | Head To Toe Chiropractic, Pllc | Chiropractor | 2500 Nesconset Highway, Building 9b, Stony Brook, NY 11790 | 2017-02-27 |
| 1194947085 | Dawn M Diecidue | Nurse Practitioner | 2500 Nesconset Highway, Building 23, Stony Brook, NY 11790 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1801167895 | Reza Dashti | Neurological Surgery | New York Spine and Brain Surgery Hsc T12 Rm 080, Stony Brook, NY 11794 | 2012-01-23 |
| 1467741884 | Courtney Pendleton | Neurological Surgery | 100 Nicholls Road Hsc T12 Rm 080, Stony Brook, NY 11794-0001 | 2011-04-06 |
| 1124254917 | Charles Bazemore Mikell IIi | Neurological Surgery | Hsc T12, Room 080, Stony Brook, NY 11794-8122 | 2009-06-07 |
| 1427345198 | Lissa Peeling | Neurological Surgery | Stony Brook University Medical Ctr, Hsc T12-rm 060, Stony Brook, NY 11794-8122 | 2011-07-01 |
| 1679718670 | Neuro Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy, Bldg. 18, Suite 69, Stony Brook, NY 11790-2555 | 2008-12-05 |
| 1669638540 | Magdy Shady Neurosurgeon PC | Neurological Surgery | 2500 Nesconset Hwy, Bldg 18c, Stony Brook, NY 11790-2555 | 2008-07-31 |
| 1073556437 | Magdy Shawky Shady | Neurological Surgery | 2500 Nesconset Hwy, Building 18c, Stony Brook, NY 11790-2555 | 2006-06-14 |
| 1154376309 | New York Spine & Brain Surgery, University Faculty Practice Corporatio | Neurological Surgery | Suny @ Stony Brook, Hsc, L12, Rm 080, Stony Brook, NY 11794-0001 | 2006-05-24 |
| 1982652848 | Henry H Woo | Neurological Surgery | 101 Nicolls Rd, Cv Center, Hosp Level 4, Rm 430, Stony Brook, NY 11794-7447 | 2006-05-04 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11790 |
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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.