ETINOSA OTAGHO


Address: 27005 76th Ave, New Hyde Park, NY 11040-1496
Phone: 7184707000

ETINOSA OTAGHO (NPI# 1538717103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 27005 76TH AVE
City NEW HYDE PARK
State NY
Zip Code 11040-1496

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City NEW HYDE PARK
Zip Code 11040

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Dataset Information

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.

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