VADJISTA BROUMAND (NPI# 1376537308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376537308 |
| Entity Type | Individual |
| Full Name | VADJISTA BROUMAND |
| Credential | MD |
| Practice Address |
4110 Medical Center Dr Suite 110 Fayetteville NY 13066 |
| Practice Telephone | 3156630100 |
| Practice Fax Number | 3156630052 |
| Mailing Telephone | 3156630100 |
| Mailing Fax Number | 3156630052 |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2014-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 235818 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
4110 MEDICAL CENTER DR SUITE 110 |
| City | FAYETTEVILLE |
| State | NY |
| Zip Code | 13066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336510916 | Melissa Roe | Physician Assistant | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2015-10-08 |
| 1871848481 | Meghan L Doran | Nurse Practitioner | 4110 Medical Center Dr, Suite 100, Fayetteville, NY 13066-6613 | 2012-07-19 |
| 1023247608 | Jessica Faye Bouchard | Physician Assistant | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2009-07-05 |
| 1558507251 | Rachel Marie Damon | Physician Assistant | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2008-12-30 |
| 1336235639 | Dermatology Associates of Central New York Pllc | Dermatology | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2006-10-05 |
| 1992756209 | Ellen E Powers | Nurse Practitioner | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2006-05-12 |
| 1215991005 | Amin Fazeli | Dermatology | 4110 Medical Center Dr, Suite 110, Fayetteville, NY 13066-6613 | 2006-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
| Find all providers in zip 13066 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265066955 | Thomas W Atkinson Md Pa | Internal Medicine | 1670 East Joyce Blvd Suite 2, Fayetteville, AR 72703-0030 | 2020-03-03 |
| 1992171078 | Ferncreek Primary Care, PC | Internal Medicine | 1314 Medical Dr Ste 102, Fayetteville, NC 28304 | 2015-08-12 |
| 1356734917 | Deepinder Kaur | Internal Medicine | 109 Shadow Oak Ln, Fayetteville, NC 28303-5015 | 2015-03-06 |
| 1154736510 | George Augustine Blewitt Sr. | Internal Medicine | 6902 Saint Annes Dr, Fayetteville, PA 17222-9456 | 2014-06-24 |
| 1497166623 | Johnny Harris II | Internal Medicine | 105 Carnegie Pl Ste 103, Fayetteville, GA 30214 | 2014-05-09 |
| 1255754719 | Phanindar Reddy Sadhu | Internal Medicine | Cape Fear Valley Medical Associates, 1638 Owen Drive, Fayetteville, NC 28302-2000 | 2014-02-03 |
| 1184069015 | Trey Becton | Internal Medicine | 3215 N North Hills Blvd., Fayetteville, AR 72703-4424 | 2013-05-06 |
| 1497093900 | Daniel Leon Harris | Internal Medicine | 14 Wheeler Ave, Fayetteville, NY 13066-2531 | 2013-01-18 |
| 1053669002 | Statcare,llc | Internal Medicine | 9525 Cliffdale Rd, Fayetteville, NC 28304-5956 | 2012-08-23 |
| 1104113059 | Chompunut Asava Aree | Internal Medicine | 4224 Ferncreek Dr, Fayetteville, NC 28314-2515 | 2011-06-29 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 13066 |
Please comment or provide details below to improve the information on VADJISTA BROUMAND.
| 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.