JOSEPH JOHN STAMBOULY (NPI# 1427062561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427062561 |
| Entity Type | Individual |
| Full Name | JOSEPH JOHN STAMBOULY |
| Credential | M.D. |
| Practice Address |
259 1st St Mineola NY 11501-3957 |
| Mailing Address |
222 Station Plz N Suite 611 Mineola NY 11501-3808 |
| Practice Telephone | 5166632288 |
| Practice Fax Number | 5166638955 |
| Mailing Telephone | 5166632532 |
| Mailing Fax Number | 5166632233 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
181725 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01402377 | 05 |
| Street Address |
259 1ST ST |
| City | MINEOLA |
| State | NY |
| Zip Code | 11501-3957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801892641 | Frederick James | Nurse Anesthetist, Certified Registered | 259 1st St, Mineola, NY 11501-3957 | 2005-06-27 |
| 1164039855 | James Jacob | Nurse Anesthetist, Certified Registered | 259 1st St, Mineola, NY 11501-3957 | 2020-09-26 |
| 1649887530 | Michael D'alto | Emergency Medicine | 259 1st St, Mineola, NY 11501-3957 | 2020-09-25 |
| 1174136121 | Anatoliy Mirkin | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-08-28 |
| 1497368823 | Sajumon K Joseph | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-08-25 |
| 1730707134 | Nathan Augustus Starkman | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-07-12 |
| 1164040143 | Melissa Dale Kersch | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-07-07 |
| 1518582964 | Jennifer Behbodikhah | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-06-11 |
| 1912521386 | Samuel Baskharoun | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-06-02 |
| 1346863404 | James Anthony Priftakis | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-05-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500350 | Steve Abraham Simon | Student in an Organized Health Care Education/Training Program | 222 Station Plaza, Suite 509, Mineola, NY 11501 | 2020-05-18 |
| 1407478167 | Frederick Milton Bosoy | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, Ny 11501, Mineola, NY 11501 | 2020-05-15 |
| 1982226130 | Katelyn Anne Fowler | Counselor | [email protected], 410 East Jericho Tpke, Mineola, NY 11501 | 2020-05-11 |
| 1225667819 | New York Dialysis Services, Inc | Clinic/Center | 1 East Jericho Turnpike, Mineola, NY 11501 | 2020-04-06 |
| 1518500032 | Irina Victoria Kushnareva | Social Worker | 126 Saville Rd, Mineola, NY 11501 | 2019-10-28 |
| 1861046336 | Milagros M Matias | Case Manager/Care Coordinator | 39 E. Jericho Turnpike, Mineola, NY 11501 | 2019-08-01 |
| 1154974244 | Bahram Dabiri | Student in an Organized Health Care Education/Training Program | 222 Station Plaza N., Suite 620 Mineola, Mineola, NY 11501 | 2019-07-18 |
| 1972168748 | Nabeel A. Arain | Physician Assistant | 251 1st St., Mineola, NY 11501 | 2019-05-07 |
| 1598328940 | Ramsha Jabbar | Student in an Organized Health Care Education/Training Program | 222 Station Plaza North, Suite 305, Mineola, NY 11501 | 2019-04-20 |
| 1235628850 | Valentyna Erstenyuk | Student in an Organized Health Care Education/Training Program | 222 Station Plaza N, Suite 611, Mineola, NY 11501 | 2018-05-09 |
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| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265741276 | Kalgi Mody | Pediatrics | 23 Richlee Ct, Apt 3s, Mineola, NY 11501-3647 | 2010-09-26 |
| 1831112101 | Maria Lyn Quintos-alagheband | Pediatrics | 259 1st St, Mineola, NY 11501-3957 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235631250 | Adi Avniel Aran | Pediatrics | 2600 Netherland Ave Apt 1720, Bronx, NY 10463-4838 | 2018-03-06 |
| 1518200203 | Kelly Haque | Pediatrics | 525 E 68th St # M-508, New York, NY 10065-4870 | 2013-04-01 |
| 1053654822 | Ami J Shah | Pediatrics | 424 E 34th St Fl Street9, New York, NY 10016-4901 | 2013-03-31 |
| 1841538295 | Binayak Sigdel | Pediatrics | 3242 Suson Ct, Apartment 2, St Louis, NY 10451-5504 | 2013-01-18 |
| 1063775955 | Marguerite Orsi Canter | Pediatrics | 1705 1st Ave, Apt 4fn, New York, NY 10128-4905 | 2012-06-17 |
| 1255629887 | Emily Wasserman | Pediatrics | 525 E 68th St # 6-south, New York, NY 10065-4870 | 2011-07-17 |
| 1295025310 | Grace Lee Ker | Pediatrics | 101 Nicolls Rd # Level11n, Stony Brook, NY 11794-0001 | 2011-04-11 |
| 1093031478 | Erin Whitney Hulfish | Pediatrics | Hsc Level 11, Room 020, Stony Brook, NY 11794-0001 | 2010-04-11 |
| 1689996514 | Mary Kathleen Moynihan Hardart | Pediatrics | 4 Locust Ln, Bronxville, NY 10708-4916 | 2010-02-19 |
| 1023341583 | Rishma Chand | Pediatrics | 344 W 12th St, Apt 3d, New York, NY 10014-1707 | 2009-09-15 |
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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.