DR. BRENT A ENNISS (NPI# 1558709352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558709352 |
| Entity Type | Individual |
| Full Name | DR. BRENT A ENNISS |
| Credential | DO |
| Practice Address |
766 Irving Ave Syracuse NY 13210 |
| Mailing Address |
117 Brookbend Cibolo TX 78108-3283 |
| Practice Telephone | 7204682480 |
| Mailing Telephone | 7204682480 |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2018-05-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZB0001X |
Pathology Specialization: Blood Banking & Transfusion Medicine |
1337 | NE | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | BP10048437 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
766 IRVING AVE |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487263034 | Nicholas Bender | Student in an Organized Health Care Education/Training Program | 766 Irving Ave, Syracuse, NY 13210-1630 | 2020-07-29 |
| 1851915508 | Ashraf A. Patel | Student in an Organized Health Care Education/Training Program | 766 Irving Ave, Syracuse, NY 13210-1630 | 2020-05-28 |
| 1235769514 | Sydney Hannah Russell Leed | Student in an Organized Health Care Education/Training Program | 766 Irving Ave, Syracuse, NY 13210-1630 | 2020-01-24 |
| 1649766577 | Emily Mckay Procopio | Nurse Practitioner | 766 Irving Ave, Syracuse, NY 13210-1630 | 2018-07-03 |
| 1336644400 | Vlad Panaitescu | Emergency Medicine | 766 Irving Ave, Syracuse, NY 13210-1630 | 2018-03-29 |
| 1366977001 | Travis Evan Quinn | Student in an Organized Health Care Education/Training Program | 766 Irving Ave, Syracuse, NY 13210 | 2017-05-01 |
| 1972992998 | Vanessa Gera | Clinical Nurse Specialist | 766 Irving Ave, Syracuse, NY 13210-1630 | 2015-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
| 1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
| 1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
| 1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
| 1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
| 1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
| 1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
| 1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
| Find all providers in zip 13210 | ||||
| Taxonomy Code | 207ZB0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Blood Banking & Transfusion Medicine |
| A physician who specializes in blood banking/transfusion medicine is responsible for the maintenance of an adequate blood supply, blood donor and patient-recipient safety and appropriate blood utilization. Pre-transfusion compatibility testing and antibody testing assure that blood transfusions, when indicated, are as safe as possible. This physician directs the preparation and safe use of specially prepared blood components, including red blood cells, white blood cells, platelets and plasma constituents, and marrow or stem cells for transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pathology. The Certification is NO longer provided. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053364802 | Christian N Ezidiegwu | Pathology | 100 Ostrom Ave, Syracuse, NY 13210-2029 | 2006-05-19 |
| 1164642971 | Zhanna Spektor | Pathology | 750 E. Adams Street, Syracuse, NY 13210 | 2007-04-26 |
| 1114031879 | Lazaro Rosales | Pathology | 750 E Adams St, Syracuse, NY 13210-2306 | 2006-08-19 |
| 1497869234 | Sylva Bem | Pathology | 750 E Adams St, Syracuse, NY 13210-2306 | 2006-08-18 |
| 1033150917 | University Pathologists Laboratories, LLP | Pathology | 550 Harrison St, Suite 220, Syracuse, NY 13202-3096 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396237137 | Lisa Thuyan Huynh | Pathology | 345a Liberty Ave, Staten Island, NY 10305-2213 | 2018-06-06 |
| 1669880233 | Linda Mamone | Pathology | 101 Nicolls Rd Rm 710, Stony Brook, NY 11794-0001 | 2014-07-28 |
| 1962775338 | Gail Moskowitz | Pathology | 45 West 60th Street, Suite 16g, New York, NY 10023-7943 | 2012-02-16 |
| 1831425479 | Avrum H. Golub | Pathology | 547 Asharoken Ave, Northport, NY 11768-1121 | 2009-11-01 |
| 1881874642 | Fay West | Pathology | 40 Sunshine Cottage Rd, Skyline Bldg, #1n-j14, New York Medical College Dept Peds Heme Onc, Valhalla, NY 10595 | 2007-11-09 |
| 1962605972 | Therese Martin Dimaio | Pathology | 325 East 57th Street, Apt 4b, New York, NY 10022 | 2007-06-07 |
| 1891903258 | New York Downtown Pathology | Pathology | 170 William St # 706, New York, NY 10038-2612 | 2007-05-18 |
| 1720295702 | Visalam Chandrasekaran | Pathology | The New York Blood Center, 310, E 67 Street, New York, NY 10021 | 2007-05-17 |
| 1528193968 | John William Burch | Pathology | 825 John St, West Henrietta, NY 14586-9790 | 2007-02-23 |
| 1417097387 | Allan Rongguo Li | Pathology | Linden Blvd and Brookdale Plaza, Brooklyn, NY 11212 | 2007-02-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. BRENT A ENNISS.
| 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.