JENNIFER FIDELO (NPI# 1508077058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508077058 |
| Entity Type | Individual |
| Full Name | JENNIFER FIDELO |
| Credential | NP |
| Practice Address |
994 W Jericho Tpke Suite 202 Smithtown NY 11787-3235 |
| Practice Telephone | 6314745800 |
| Practice Fax Number | 6318649201 |
| Mailing Telephone | 6314745800 |
| Mailing Fax Number | 6318649201 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 400712 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
994 W JERICHO TPKE SUITE 202 |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-3235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689677197 | Long Island Skin Cancer and Dermatologic Surgery, PC | Specialist | 994 W Jericho Tpke, Ste 103, Smithtown, NY 11787-3211 | 2005-05-30 |
| 1013402932 | Rachel Anne Demaio | Nurse Practitioner | 994 W Jericho Tpke, Smithtown, NY 11787-3235 | 2018-06-22 |
| 1366873259 | Delta Sleep Center | Sleep Specialist, PhD | 994 W Jericho Tpke, Smithtown, NY 11787-3235 | 2013-12-03 |
| 1184999344 | Melinda Clarke | Registered Nurse | 994 W Jericho Tpke, Smithtown, NY 11787-3235 | 2012-03-20 |
| 1134457518 | Allison Wallshein | Registered Nurse | 994 W Jericho Tpke, Suite 202, Smithtown, NY 11787-3235 | 2009-11-24 |
| 1538302179 | Gulle Nayab Awan | Pain Medicine | 994 W Jericho Tpke, Suite 104, Smithtown, NY 11787-3235 | 2009-04-13 |
| 1245407519 | Michele A Morganstern | Psychologist | 994 W Jericho Tpke, Suite 202, Smithtown, NY 11787-3235 | 2008-05-14 |
| 1235303157 | Lloyd D. Landsman, M.d.p.c. | Plastic Surgery | 994 W Jericho Tpke, Smithtown, NY 11787-3235 | 2008-04-22 |
| 1851595094 | Long Island Skin Cancer & Dermatologic Surgery, PC | Dermatology | 994 W Jericho Tpke, Suite 103, Smithtown, NY 11787-3235 | 2007-06-12 |
| 1013071323 | Karin Eva Burkhard | Psychiatry & Neurology | 994 W Jericho Tpke, Suite 202, Smithtown, NY 11787-3235 | 2006-12-21 |
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| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760029649 | Danielle Domini | Physician Assistant | 260 E Middle Country Rd Ste 208, Smithtown, NY 11787-2925 | 2019-12-10 |
| 1245882075 | Brianna Metzger | Physician Assistant | 58 Stony Hill Path, Smithtown, NY 11787-1137 | 2019-07-11 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1922496900 | Nikolaos Kapsalis | Physician Assistant | 321 E Middle Country Rd, Smithtown, NY 11787-2820 | 2014-12-29 |
| 1659504207 | Kathleen Osman | Physician Assistant | 50 New York Ave # 25a, Smithtown, NY 11787-3448 | 2009-08-31 |
| 1629228903 | Dana Jean Lamparter | Physician Assistant | 50 Route 25a # E, Smithtown, NY 11787-1348 | 2008-09-24 |
| 1689895989 | Ameet Kaur Perez | Physician Assistant | 222 Middle Country Rd Ste 228, Smithtown, NY 11787-2873 | 2007-05-02 |
| 1427132018 | Kimberly Ann Cossaro | Physician Assistant | 327 E Main St, Smithtown, NY 11787-2905 | 2006-10-24 |
| 1982701603 | Jose L Perez | Physician Assistant | 50 Rte 25a, Smithtown, NY 11787-1348 | 2006-09-17 |
| 1962492389 | Barbara Cartabuke-mule | Physician Assistant | 329 Middle Country Rd, Suite 9 Primary Medical Care of Suffolk County PC, Smithtown, NY 11787-2830 | 2005-10-26 |
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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.