JACLYN C CORNELL (NPI# 1548633001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548633001 |
| Entity Type | Individual |
| Full Name | JACLYN C CORNELL |
| Other Name | JACLYN C GALIETTI |
| Credential | PA-C |
| Practice Address |
4271 Hempstead Tpke Suite 1 Bethpage NY 11714-5708 |
| Practice Telephone | 5167963700 |
| Practice Fax Number | 5167963205 |
| Mailing Telephone | 5167963700 |
| Mailing Fax Number | 5167963205 |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2019-04-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 019303 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4271 HEMPSTEAD TPKE SUITE 1 |
| City | BETHPAGE |
| State | NY |
| Zip Code | 11714-5708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659316826 | Irina V Shpak | Internal Medicine | 4271 Hempstead Tpke, Suite 1, Bethpage, NY 11714 | 2006-06-19 |
| 1912531526 | Brian Alvarez | Counselor | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2020-02-24 |
| 1033628797 | Shari Ashkin | Counselor | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2017-09-26 |
| 1316456056 | Brent Russell | Social Worker | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2017-09-26 |
| 1154862662 | Breanna Fred | Social Worker | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2017-03-16 |
| 1316497043 | Michael Walters | Social Worker | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2016-10-05 |
| 1932560273 | Jason Moston | Social Worker | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2016-03-15 |
| 1538526843 | Winthrop Community Medical Affiliates PC | Internal Medicine | 4271 Hempstead Tpke, Suite 1, Bethpage, NY 11714-5708 | 2016-01-19 |
| 1871979989 | Claudia Hutchinson-stewart | Counselor | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2015-07-31 |
| 1043699358 | Megan Marrero | Counselor | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2015-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023466208 | Angelika Cataldo | Physician Assistant | 96 Farmers Ave, Bethpage, NY 11714 | 2016-05-30 |
| 1215390240 | Jessica Cohen Micciulli | Counselor | 1211 Stewart Ave., Suite 100, Bethpage, NY 11714 | 2016-03-29 |
| 1295119329 | Van Tu | Physician Assistant | 72 Roosevelt Dr, Bethpage, NY 11714 | 2015-07-18 |
| 1124400072 | Nicole Simon | Speech-Language Pathologist | 28 Lee Avenue, Bethpage, NY 11714 | 2015-06-26 |
| 1083001556 | Gagandeep Sharma | Podiatrist | 255 Stewart Ave, Bethpage, NY 11714 | 2015-04-22 |
| 1245631399 | All About Kids | Local Education Agency (LEA) | 152 Sycamore Avenue, Bethpage, NY 11714 | 2014-09-09 |
| 1568871440 | Christina Healy | Home Health Aide | 49 West Millpage Drive, Bethpage, NY 11714 | 2014-08-05 |
| 1225444656 | Ryan Vincent Costello | Registered Nurse | 68 S. 2nd St., Apt A, Bethpage, NY 11714 | 2014-07-07 |
| 1598195125 | Lori-ann Perez | Case Manager/Care Coordinator | 18 Ellen Street, Bethpage, NY 11714 | 2013-11-18 |
| 1306195482 | Lisa Kozlowsky | Behavioral Analyst | 420 Kensington Lane, Bethpage, NY 11714 | 2012-09-05 |
| Find all providers in zip 11714 | ||||
| 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 |
|---|---|---|---|---|
| 1023466208 | Angelika Cataldo | Physician Assistant | 96 Farmers Ave, Bethpage, NY 11714 | 2016-05-30 |
| 1295119329 | Van Tu | Physician Assistant | 72 Roosevelt Dr, Bethpage, NY 11714 | 2015-07-18 |
| 1538495205 | Lauren N Keller | Physician Assistant | 4271 Hempstead Tpke Ste 1, Bethpage, NY 11714 | 2009-10-30 |
| 1457514028 | Sophia Theodora Combest-markotsis | Physician Assistant | 4277 Hempstead Tpke Ste 102, Bethpage, NY 11714-5706 | 2008-07-03 |
| 1396210092 | Samantha Mayer | Physician Assistant | 480 Hicksville Rd, Bethpage, NY 11714-3415 | 2018-10-09 |
| 1063997799 | Zeba Memon | Physician Assistant | 4295 Hempstead Tpke, Bethpage, NY 11714-5713 | 2018-09-27 |
| 1871085225 | Meghan Christine Rowland | Physician Assistant | 4295 Hempstead Tpke, Bethpage, NY 11714-5713 | 2018-06-01 |
| 1003262213 | James Bantel | Physician Assistant | 4295 Hempstead Tpke, Bethpage, NY 11714-5713 | 2016-05-05 |
| 1831443332 | Patricia Mary Roehrig | Physician Assistant | 4295 Hempstead Tpke, Bethpage, NY 11714-5713 | 2012-11-05 |
| 1487968715 | Kathryn Dorothy Buckman | Physician Assistant | 4271 Hempstead Tpke, Suite 1, Bethpage, NY 11714-5708 | 2010-07-28 |
| Find all providers in BETHPAGE | ||||
Please comment or provide details below to improve the information on JACLYN C CORNELL.
| 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.