ETINOSA OTAGHO (NPI# 1538717103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1538717103 |
Entity Type | Individual |
Full Name | ETINOSA OTAGHO |
Practice Address |
27005 76th Ave New Hyde Park NY 11040-1496 |
Mailing Address |
21711 130th Ave Springfield Gardens NY 11413-1204 |
Practice Telephone | 7184707000 |
Enumeration Date | 2019-08-27 |
Last Update Date | 2019-08-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
27005 76TH AVE |
City | NEW HYDE PARK |
State | NY |
Zip Code | 11040-1496 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417950817 | Maria C Adragna | Anesthesiology | 27005 76th Ave, New Hyde Park, NY 11040-1433 | 2005-05-31 |
1730789538 | Daniela Farzadfar | Pharmacist | 27005 76th Ave, New Hyde Park, NY 11040-1402 | 2020-10-29 |
1669072096 | Barbara Barsoum | Pharmacist | 27005 76th Ave, New Hyde Park, NY 11040-1402 | 2020-10-26 |
1962000547 | Dana Rucco | Pharmacist | 27005 76th Ave, New Hyde Park, NY 11040-1496 | 2020-10-15 |
1407454200 | Jessica Marie Maas | Pharmacist | 27005 76th Ave, New Hyde Park, NY 11040-1402 | 2020-10-14 |
1407463318 | Lori Ohanesian | Pharmacist | 27005 76th Ave, New Hyde Park, NY 11040-1496 | 2020-09-24 |
1063029106 | Nicole Mulvey | Pharmacist | 27005 76th Ave, New Hyde Park, NY 11040-1496 | 2020-09-23 |
1528674314 | William Christopher Arthur | Pharmacist | 27005 76th Ave, New Hyde Park, NY 11040-1402 | 2020-09-17 |
1508470238 | Kiara Goldwag | Registered Nurse | 27005 76th Ave, New Hyde Park, NY 11040-1402 | 2020-09-01 |
1710590948 | Laura Calcagni | Nurse Practitioner | 27005 76th Ave, New Hyde Park, NY 11040-1402 | 2020-08-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598366734 | Naurin Shaki | Case Management | 108 Bryant Ave, New Hyde Park, NY 11040 | 2020-11-04 |
1326645920 | Oksana Isakharov | Marriage & Family Therapist | Remote Telehealth Due To Pandemic, Remote Telehealth Due To Pandemic, NY 11040 | 2020-10-06 |
1639784036 | Michelle Edith Narain | Nurse Practitioner | 270-05 76th Aveune, New Hyde Park, NY 11040 | 2020-09-11 |
1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
1851929384 | Hollie Brown | Student in an Organized Health Care Education/Training Program | 45 Lakeville Rd Ste M41, New Hyde Park, NY 11040 | 2020-03-30 |
1780211797 | Miriam Tarrash | Student in an Organized Health Care Education/Training Program | Lijmc, 270-05 76th Avenue, New Hyde Park, NY 11040 | 2020-03-27 |
1902438971 | Kristina Petrich | Student in an Organized Health Care Education/Training Program | Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040 | 2020-02-07 |
1528622735 | David Olatunji Omole | Dentist | 270-05 76th Avenue Dept. of Dental Medicine / Oral And, Surgery New Hyde Park, Ny, Ny 11040, New Hyde Park, NY 11040 | 2019-04-24 |
1720642093 | Thanzina Chowdhury | Pharmacy | 271-11 76th Ave, Queens, NY 11040 | 2019-04-23 |
1427519834 | Connor William Crowley | Student in an Organized Health Care Education/Training Program | Office of Surgical Education Victoria M. Waithe, 270-05 76th Avenue. Research Bldg - C Level Room 039ab, New Hyde Park, NY 11040 | 2019-03-28 |
Find all providers in zip 11040 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396023511 | Merin M Thomas | Physician Assistant | 5 Nortema Ct, New Hyde Park, NY 11040-2031 | 2011-07-22 |
1750672556 | Sundeep Kaur Singh | Physician Assistant | 3 Sperry Ct, New Hyde Park, NY 11040-3819 | 2011-04-27 |
1013002104 | Matthew L. Shebes | Physician Assistant | Long Island Jewish Medical Center-department of Surgery, 270-05, 76 Ave, New Hyde Park, NY 11042 | 2006-10-04 |
1912518184 | Jonathan Phua | Physician Assistant | 3003 New Hyde Park Rd, New Hyde Park, NY 11042-1206 | 2020-08-12 |
1619457967 | Kelly Madeline Lynch | Physician Assistant | 2800 Marcus Ave, New Hyde Park, NY 11042-1113 | 2018-08-16 |
1275039141 | Joan Claire Zimmeck | Physician Assistant | 3003 New Hyde Park Rd Ste 309, New Hyde Park, NY 11042-1214 | 2018-04-01 |
1487167094 | Ruth Sarai Walter | Physician Assistant | 270-05 76th Ave, New Hyde Park, NY 11040-1402 | 2017-11-06 |
1740646405 | Bindu Abbey Daniel | Physician Assistant | 27005 76th Ave, New Hyde Park, NY 11040-1402 | 2016-01-11 |
1134596810 | Dayna Glatzer | Physician Assistant | 2800 Marcus Ave, New Hyde Park, NY 11042-1113 | 2015-08-28 |
1407232390 | Katherine Elizabeth Beam | Physician Assistant | 1991 Marcus Ave Ste 102, New Hyde Park, NY 11042-2062 | 2015-08-03 |
Find all providers in NEW HYDE PARK |
City | NEW HYDE PARK |
Zip Code | 11040 |
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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.