ADVANCED COLON AND RECTAL SURGERY, PC (NPI# 1447498209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447498209 |
| Entity Type | Organization |
| Organization Name | ADVANCED COLON AND RECTAL SURGERY, PC |
| Practice Address |
510 Broadhollow Rd Suite 307 Melville NY 11747-3671 |
| Practice Telephone | 6317562888 |
| Practice Fax Number | 6317562880 |
| Mailing Telephone | 6317562888 |
| Mailing Fax Number | 6317562880 |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |
| Authorized Official Name | DR. BRADLEY G BUTE (PRESIDENT) |
| Authorized Official Telephone | 6317562888 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
2441325 | NY | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
2441325 | NY | Ambulatory Health Care Facilities |
| Street Address |
510 BROADHOLLOW RD SUITE 307 |
| City | MELVILLE |
| State | NY |
| Zip Code | 11747-3671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841251956 | Scott A Siegel | Dentist | 510 Broadhollow Rd, Suite 130, Melville, NY 11747-3671 | 2006-03-29 |
| 1699090555 | Mitchell B. Shaw | Dentist | 510 Broadhollow Rd, Suite 130, Melville, NY 11747-3671 | 2010-04-05 |
| 1174853782 | Danielle M Toto | Social Worker | 510 Broadhollow Rd, Suite 202, Melville, NY 11747-3671 | 2010-01-04 |
| 1518176841 | Doreen Lobato Frank | Physician Assistant | 510 Broadhollow Rd, Suite 112, Melville, NY 11747-3671 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891316139 | Shaina Flanzraich | Physical Therapist | 3237 1800 Walt Whitman Rd, 120, Melville, NY 11747 | 2020-04-28 |
| 1952943763 | Liana Danielle Maher | Behavior Technician | 225 Broadhallow Road Suite 402, Melville, NY 11747 | 2019-10-14 |
| 1114402096 | Anicka Inez Douglas | Behavior Technician | 225 Broadhollow Road Suite 402, Melville, NY 11747 | 2018-09-26 |
| 1962988717 | Brien Nina-louise Potter | Behavior Technician | 225 Broadhollow Road, Suite 402, Melville, NY 11747 | 2018-07-16 |
| 1750804951 | Iri: Innovative Resources for Independence | Intermediate Care Facility, Mentally Retarded | 922 Rainbow Commons Ct, Melville, NY 11747 | 2017-07-19 |
| 1386178127 | Marissa Zydor | Specialist | 538 Ny-110 #202, Melville, NY 11747 | 2017-04-19 |
| 1992236624 | Annmarie Irene Russo | Behavior Technician | 538 Ny-110, Suite 202, Melville, NY 11747 | 2017-03-24 |
| 1205378130 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 914 Rainbow Commons, Melville, NY 11747 | 2016-11-09 |
| 1932641867 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 917 Rainbow Commons, Melville, NY 11747 | 2016-11-09 |
| 1740732999 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 924 Rainbow Commons, Melville, NY 11747 | 2016-11-03 |
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| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1437516069 | Nissi Diabetes Care Np-adult Health P.C. | Clinic/Center | 437 Old Country Rd, Melville, NY 11747-1819 | 2016-01-27 |
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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.