DR. SHELDON G FAGEN (NPI# 1376649657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376649657 |
| Entity Type | Individual |
| Full Name | DR. SHELDON G FAGEN |
| Credential | MD |
| Practice Address |
994 W Jericho Tpke Ste 201 Smithtown NY 11787-3234 |
| Practice Telephone | 6318644499 |
| Practice Fax Number | 6318646023 |
| Mailing Telephone | 6318644499 |
| Mailing Fax Number | 6318646023 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2012-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 096746 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00373900 | 05 |
| Street Address |
994 W JERICHO TPKE STE 201 |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-3234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316405368 | Taylor H Abo-hamzy | Physician Assistant | 994 W Jericho Tpke Ste 201, Smithtown, NY 11787-3234 | 2019-03-08 |
| 1609032887 | Roberta A Bianco Dopc | Clinic/Center | 994 W Jericho Tpke Ste 201, Smithtown, NY 11787 | 2008-08-06 |
| 1841453057 | Farzana Aziz | Internal Medicine | 994 W Jericho Tpke Ste 201, Smithtown, NY 11787-3234 | 2008-07-08 |
| 1265559884 | Ruth G. Diaz Md PC | Internal Medicine | 994 W Jericho Tpke Ste 201, Smithtown, NY 11787-3234 | 2007-03-26 |
| 1508962705 | Richard B Lewin | Internal Medicine | 994 W Jericho Tpke Ste 201, Smithtown, NY 11787-3234 | 2006-09-15 |
| 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 | 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 |
|---|---|---|---|---|
| 1194025973 | Long Island Gastroenterology and Liver Disease P.C. | Internal Medicine | 48 Route 25a Ste 307, Smithtown, NY 11787-1454 | 2010-10-27 |
| 1760629919 | Kanika Kaur | Internal Medicine | 48 Route 25a Ste 105, Smithtown, NY 11787-1447 | 2009-01-09 |
| 1790943694 | Kanwar Iqbal Singh Gill | Internal Medicine | 300 E Main St Ste 6, Smithtown, NY 11787-2900 | 2008-05-28 |
| 1902072176 | Med Tech Medical Diagnostics PC | Internal Medicine | 1056 Jericho Tpke, Smithtown, NY 11787-3212 | 2008-05-07 |
| 1780881680 | Chun Chen | Internal Medicine | 278 E Main St Ste A, Smithtown, NY 11787-2915 | 2007-07-02 |
| 1922156132 | E.lila Augoustiniatos, Md, PC | Internal Medicine | 100 Terry Road, Smithtown, NY 11787-3811 | 2007-01-07 |
| 1669561940 | Eileen M Barr | Internal Medicine | 100 Terry Rd, Smithtown, NY 11787-3811 | 2006-10-12 |
| 1811901200 | David Michael Horowitz | Internal Medicine | 2 Brooksite Drive, Suite 210, Smithtown, NY 11787-3492 | 2006-07-28 |
| 1467466581 | James Robert Powell | Internal Medicine | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2006-07-27 |
| 1538182845 | Robert C Johnson | Internal Medicine | 267 East Main St, Bldg A, Smithtown, NY 11787 | 2006-07-26 |
| Find all providers in SMITHTOWN | ||||
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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.