PHILIP MANTIA (NPI# 1487652343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487652343 |
| Entity Type | Individual |
| Full Name | PHILIP MANTIA |
| Credential | MD |
| Practice Address |
59 Southern Blvd Nesconset NY 11767-1090 |
| Practice Telephone | 6316591700 |
| Practice Fax Number | 6316591750 |
| Mailing Telephone | 6316591700 |
| Mailing Fax Number | 6316591750 |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2012-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 094617 | NY | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
094617 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00155862-1 | 05 |
| Street Address |
59 SOUTHERN BLVD |
| City | NESCONSET |
| State | NY |
| Zip Code | 11767-1090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588662829 | Augustus G Mantia | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2005-07-11 |
| 1659677037 | Mount Sinai North Shore Medical Group | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2011-02-02 |
| 1962646091 | North Shore Medical Group of The Mount Sinai School of Medicine | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2009-04-20 |
| 1841436458 | Barbara Lynn Stumacher | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2009-01-02 |
| 1952547945 | David Henry Oustecky | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2008-12-23 |
| 1265616452 | Lori Weber | Nurse Practitioner | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2007-12-24 |
| 1669535845 | Harley J Cohen | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2006-12-18 |
| 1316957707 | Joanne M. Kechejian | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2006-08-08 |
| 1871520049 | Glenn Rosett | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2006-06-26 |
| 1184660003 | Marilena Mirica | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2006-06-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487183877 | Robert Walter Hickey | Pharmacist | 115 Sheppard Ln, Nesconset, NY 11767 | 2017-06-08 |
| 1730621517 | James Remien | Massage Therapist | 62 Lake Ave South, Suite C, Nesconset, NY 11767 | 2016-11-10 |
| 1063788578 | Stacy Lynne Heuschneider | Nurse Practitioner | 48 Locust Drive, Nesconset, NY 11767 | 2012-03-29 |
| 1538485511 | Christina Ferlise-clark | Social Worker | 206 Nichols Rd, Nesconset, NY 11767 | 2010-04-15 |
| 1982843017 | Sharon Frances Devivo | Registered Nurse | 45 Rockey Point Road, Middle Island, NY 11767 | 2009-02-12 |
| 1649429523 | Justin Tate | Occupational Therapist | 14 Suburban Lane, Nesconset, NY 11767 | 2008-09-16 |
| 1386801520 | Helene Ann Hopkins Farley | Registered Nurse | 65 Tiffany Way, Nesconset, NY 11767 | 2008-05-16 |
| 1992978456 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 200 A Gibbs Pond Rd, Nesconset, NY 11767 | 2008-04-07 |
| 1205019403 | Sherrie Glasser Physical Therapy/john Douglas Pta | Specialist | 5 Browns Rd, Nesconset, NY 11767 | 2007-12-11 |
| 1710109665 | Chiropractic Associates of Long Island PC | Chiropractor | 195 Smithtown Blvd, Ste 105, Nesconset, NY 11767 | 2007-05-02 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1891816245 | Syeda Tanzia Hossain | Internal Medicine | 61 Southern Blvd, Nesconset, NY 11767-1089 | 2007-04-03 |
| 1598199432 | North Shore Medical Group of The Mount Sinai School of Medicine | Internal Medicine | 61 Southern Blvd, Nesconset, NY 11767-1089 | 2013-08-28 |
| 1659677037 | Mount Sinai North Shore Medical Group | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2011-02-02 |
| 1952547945 | David Henry Oustecky | Internal Medicine | 59 Southern Blvd, Nesconset, NY 11767-1090 | 2008-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326645870 | Gastro 2020 Pllc | Internal Medicine | 9618 Metropolitan Ave, Forest Hills, NY 11375-6625 | 2020-10-07 |
| 1457963241 | Medical Services of Uniondale, PC | Internal Medicine | 106 Charles Lindbergh Blvd Ste B, Uniondale, NY 11553-3632 | 2020-08-21 |
| 1619586419 | Kazbay Medical Pllc | Internal Medicine | 83 Salierno Rd, Tuxedo Park, NY 10987-4712 | 2020-07-28 |
| 1487279725 | Akifa Samdani, Md PC | Internal Medicine | 120 E 86th St # 2b, New York, NY 10028-1062 | 2020-06-12 |
| 1326673559 | Jack Husney Md P.C. | Internal Medicine | 2228 E 8th St, Brooklyn, NY 11223-4944 | 2020-03-09 |
| 1669005690 | Ron Porat Jankelson | Internal Medicine | 200 E 64th St Apt 10b, New York, NY 10065-7441 | 2020-02-18 |
| 1891345666 | Jrr Medical PC | Internal Medicine | 2569 Ocean Ave Ste 3, Brooklyn, NY 11229-4576 | 2019-09-13 |
| 1497218762 | Rudoy Medical PC | Internal Medicine | 2644 E 19th St, Brooklyn, NY 11235-3303 | 2019-04-12 |
| 1194287235 | Ng Medical Brooklyn Pllc | Internal Medicine | 943 60th St # C1, Brooklyn, NY 11219-4871 | 2019-04-05 |
| 1144786682 | Health Quest Medical Practice, PC | Internal Medicine | 400 Westage Business Ctr Dr Ste 202, Fishkill, NY 12524-2266 | 2019-02-20 |
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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.