UNKNOWN SOURABH (NPI# 1356832331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356832331 |
| Entity Type | Individual |
| Full Name | UNKNOWN SOURABH |
| Practice Address |
1101 West University Drive Rochester MI 48307 |
| Mailing Address |
888 Ironwood Drive Rochester MI 48307 |
| Practice Telephone | 2486014805 |
| Practice Fax Number | 2486014908 |
| Mailing Telephone | 3463510795 |
| Mailing Fax Number | 2486014908 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2019-04-05 |
| NPI Deactivation Date | 03/08/2019 |
| NPI Reactivation Date | 2019-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 4301115796 | MI | Student, Health Care |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1101 WEST UNIVERSITY DRIVE |
| City | ROCHESTER |
| State | MI |
| Zip Code | 48307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093868234 | Donna A Dzialo | Nurse Anesthetist, Certified Registered | 1101 West University Drive, Crittenton Hospital Medical Center, Rochester, MI 48307-1863 | 2007-01-19 |
| 1457912685 | Mishita Goel | Student in an Organized Health Care Education/Training Program | 1101 West University Drive, 2 South Gme, Rochester, MI 48307 | 2019-06-27 |
| 1568878916 | Pauline Edana Zhang | Student in an Organized Health Care Education/Training Program | 1101 West University Drive, Rochester, MI 48307 | 2014-07-07 |
| 1124396809 | Brittany Lynn Kelly | Registered Nurse | 1101 West University Drive, Rochester, MI 48307 | 2011-12-08 |
| 1043517188 | Patricia A. Demsky | Nurse Practitioner | 1101 West University Drive, Behavioral Health Center, 6 West, Rochester, MI 48307-1831 | 2011-02-25 |
| 1710188529 | Ana Maria Rotar | Psychiatry & Neurology | 1101 West University Drive, Behavioral Health Center, 6 West, Rochester, MI 48307-1831 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083238851 | Martin Dukaj | Student in an Organized Health Care Education/Training Program | 1101 Walton Blvd, Rochester Hills, MI 48307 | 2020-06-08 |
| 1073151973 | Cynthia Lynn Olekszyk | Dietitian, Registered | 645 Barclay Circle, Rochester Hills, MI 48307 | 2019-12-11 |
| 1326502428 | Jessica Delia | Nurse Practitioner | 1701 E South Boulevard, Suite 290, Rochester Hills, MI 48307 | 2019-01-23 |
| 1528530037 | Kelie Friday | Physical Therapist | 312 Rochester Hills, Dearborn, MI 48307 | 2018-12-21 |
| 1538635883 | Julie Latarewicz | Physical Therapist | Ascension Providence Rochester Hospital, 1101 West University Drive, Rochester, MI 48307 | 2018-10-15 |
| 1891270757 | Leah Marx | Social Worker | 3950 Rochester Rd, Ste 2250, Rochester Hills, MI 48307 | 2018-09-26 |
| 1598256729 | Frederick Alan Bittner | Student in an Organized Health Care Education/Training Program | 1101 W. University Drive, 3 North, Rochester, MI 48307 | 2018-05-23 |
| 1508356346 | Ankita Aggarwal | Student in an Organized Health Care Education/Training Program | Wsu/ascension Crittenton Hospital, 1101 W. University Drive, Rochester, MI 48307 | 2018-05-17 |
| 1619478195 | Michelle Nuccio | Occupational Therapist | 1555 E South Blvd, Rochester Hills, MI 48307 | 2018-02-21 |
| 1265932024 | Stacy Dietlin Linn | Physical Therapist | 1555 E. South Blvd, Suite 120, Rochester Hills, MI 48307 | 2018-02-19 |
| Find all providers in zip 48307 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174130421 | Carolyne Copley | Student in an Organized Health Care Education/Training Program | 226 2nd St Sw, Rochester, MN 55905-0001 | 2020-09-29 |
| 1497362925 | Alexandra Michelle Hasiotis | Student in an Organized Health Care Education/Training Program | 36 Copperfield Rd, Rochester, NY 14615-1102 | 2020-09-29 |
| 1750905873 | Anna C Lin | Student in an Organized Health Care Education/Training Program | 419 7th Ave Sw, Rochester, MN 55902-3216 | 2020-06-04 |
| 1558985101 | Erin Marissa Hannigan | Student in an Organized Health Care Education/Training Program | 4802 8th St Sw, Rochester, MN 55902-8711 | 2020-05-29 |
| 1710501408 | Anna Dowling | Student in an Organized Health Care Education/Training Program | 609 E 2650 North Rd, Rochester, IL 62563-8108 | 2020-05-29 |
| 1689296386 | Bryan Liming Jan | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave # 632, Rochester, NY 14642-0001 | 2020-05-15 |
| 1780206474 | Robert Tainsh | Student in an Organized Health Care Education/Training Program | 601 Elmwood Avenue Box 604, Rochester, NY 14642-0001 | 2020-05-15 |
| 1578185302 | Shaahin Dadjoo | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave Ofc 683, Rochester, NY 14620-2913 | 2020-05-14 |
| 1578185534 | Starling Tolliver | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave # Ac-5696, Rochester, NY 14642-0001 | 2020-05-13 |
| 1548882707 | Christian A Archer | Student in an Organized Health Care Education/Training Program | 601 Elmwood Avenue Box Hh 37, Rochester, NY 14642-0001 | 2020-05-11 |
| 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.