NICKOLAS IZZO (NPI# 1558880815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558880815 |
| Entity Type | Individual |
| Full Name | NICKOLAS IZZO |
| Credential | PA |
| Practice Address |
5100 W Taft Rd Ste 1d Liverpool NY 13088-3808 |
| Mailing Address |
301 Prospect Ave Rm 1605 Syracuse NY 13203-1807 |
| Practice Telephone | 3157441833 |
| Practice Fax Number | 3154522336 |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2017-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5100 W TAFT RD STE 1D |
| City | LIVERPOOL |
| State | NY |
| Zip Code | 13088-3808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878966 | Anthony Edward Blumetti | Psychologist | 5100 W. Taft Road, Suite 3b, Liverpool, NY 13088 | 2019-12-12 |
| 1609350016 | Alice Nellenbach | Physical Therapy Assistant | 346 Electronics Pkwy, Liverpool, NY 13088 | 2018-09-20 |
| 1043741457 | Dawn Marie Thomas | Licensed Practical Nurse | 212 Old Liverpool Road, Building 7 Apartment 6, Liverpool, NY 13088 | 2017-03-27 |
| 1154775633 | Arielle L Leonard | Massage Therapist | 609 7th N. Street, Suite 2, Liverpool, NY 13088 | 2016-04-20 |
| 1942664362 | Accessibility Solutions, Inc. | Contractor | 115 Luther Avenue, Liverpool, NY 13088 | 2016-04-12 |
| 1497176333 | Sergey Golovko | Psychiatry & Neurology | 125 Sun Harbor Dr, Liverpool, NY 13088 | 2013-12-19 |
| 1205275286 | Brandon William Crandall | Nurse Practitioner | 5100 West Taft Rd., Suite 1c, Liverpool, NY 13088 | 2013-06-23 |
| 1184976805 | Audrey Irene Tyszka | Social Worker | 5100 W Taft Rd Ste 1f, Liverpool, NY 13088 | 2012-10-04 |
| 1790049096 | Kelley Beth Burt | Speech-Language Pathologist | 110 Elwood Davis Road, Liverpool, NY 13088 | 2012-07-02 |
| 1811288954 | Nedim Ruhotina | Urology | 100 Metropolitan Park Drive, Suite 100, Liverpool, NY 13088 | 2011-04-24 |
| Find all providers in zip 13088 | ||||
| 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 |
|---|---|---|---|---|
| 1417556408 | Breana Christine Gallagher | Physician Assistant | 235 Greenfield Pkwy, Liverpool, NY 13088-6651 | 2020-10-20 |
| 1194380352 | Michael Richard Gabriel | Physician Assistant | 4990 Sandalwood Ln, Liverpool, NY 13088-5910 | 2019-05-03 |
| 1265949267 | Ronald James Heberger | Physician Assistant | 405 Branchwood Dr, Liverpool, NY 13090-3208 | 2017-12-29 |
| 1093785537 | Debra A Wolf | Physician Assistant | 4828 W Taft Rd, Suite 215, Liverpool, NY 13088-4810 | 2006-01-26 |
| 1396748448 | Cynthia Youngmayka | Physician Assistant | 8100 Oswego Rd, Suite 220, Liverpool, NY 13090-1654 | 2005-05-23 |
| 1194380139 | Ranya Ali Hamdan | Physician Assistant | 4811 Buckley Rd, Liverpool, NY 13088-3629 | 2019-05-06 |
| 1538722608 | Margaret M Monnat | Physician Assistant | 7375 Oswego Rd, Liverpool, NY 13090-3717 | 2019-04-15 |
| 1629544051 | Grace Geno | Physician Assistant | 4811 Buckley Rd, Liverpool, NY 13088-3629 | 2018-10-24 |
| 1558846006 | Kyle Kowalewski | Physician Assistant | 7375 Oswego Rd, Liverpool, NY 13090-3717 | 2018-10-01 |
| 1487176103 | Elise Heick Blodgett | Physician Assistant | 5100 W Taft Rd Ste 1c, Liverpool, NY 13088-3808 | 2017-07-14 |
| Find all providers in LIVERPOOL | ||||
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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.