MR. MATTHEW DICICCO (NPI# 1558981233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558981233 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW DICICCO |
| Practice Address |
101 Nicholls Rd Stony Brook NY 11794-0001 |
| Mailing Address |
28 Fern St Floral Park NY 11001-3208 |
| Practice Telephone | 6316898333 |
| Mailing Telephone | 5162336949 |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 678303 | NY | Nursing Service Providers |
| Street Address |
101 NICHOLLS RD |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396767315 | Glenda Moreno | Nurse Practitioner | 101 Nicholls Rd, Stony Brook, NY 11794-0001 | 2006-07-25 |
| 1457970832 | Dorian Cohen | Student in an Organized Health Care Education/Training Program | 101 Nicholls Rd, Stony Brook, NY 11794-0001 | 2020-04-15 |
| 1326508557 | Brooke Noelle Learned | Student in an Organized Health Care Education/Training Program | 101 Nicholls Rd, Stony Brook, NY 11794-0001 | 2019-03-22 |
| 1578060414 | Albert Xiao | Student in an Organized Health Care Education/Training Program | 101 Nicholls Rd, Stony Brook, NY 11794-0001 | 2018-04-08 |
| 1649704941 | Caitlin Moran | Student in an Organized Health Care Education/Training Program | 101 Nicholls Rd, Stony Brook, NY 11794-0001 | 2017-04-13 |
| 1306379524 | Kelsi Hirai | Student in an Organized Health Care Education/Training Program | 101 Nicholls Rd, Hsc 19-030, Stony Brook, NY 11794-0001 | 2017-04-05 |
| 1811381098 | Monica Lee | Pediatrics | 101 Nicholls Rd, Stony Brook, NY 11794 | 2015-03-25 |
| 1275946147 | Brenda J Sheehan | Nurse Practitioner | 101 Nicholls Rd, Sbuh, Palliative Care Service- Hsc Level T-15, Rm.053, Stony Brook, NY 11794-0001 | 2014-06-08 |
| 1225398142 | Maria Del Mar Capo Martinez | Student in an Organized Health Care Education/Training Program | 101 Nicholls Rd, Stony Brook University Medical Center Level2-766, Stony Brook, NY 11794-7025 | 2012-05-24 |
| 1992065569 | Dhanalakshmi Balakrishnan | Student in an Organized Health Care Education/Training Program | 101 Nicholls Rd, Department of Pathology, Level 2-766, Stony Brook, NY 11794-0001 | 2012-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982263091 | Melissa Margaret Feraca | Registered Nurse | Health Sciences Tower Level 19, Room 071, Stony Brook, NY 11794-0001 | 2019-06-12 |
| 1932767514 | Liyuan Jing | Registered Nurse | 44 Malvern Ln, Stony Brook, NY 11790-2849 | 2019-05-30 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1083125389 | Ravina Chawla | Registered Nurse | 2500 Nesconset Hwy Bldg 11d, Stony Brook, NY 11790-2553 | 2017-10-13 |
| 1497199129 | Joan Hainsley | Registered Nurse | 65 University Heights Dr, Stony Brook, NY 11790-2730 | 2013-04-24 |
| 1790023471 | Maricel Anne Franzese | Registered Nurse | Hsc T12 Room 080 Dept of Neurosurgery, Stony Brook, NY 11794-8122 | 2013-01-30 |
| 1710238423 | Rose Edna Erickson | Registered Nurse | 16 Yorkshire Ave., Stony Brook, NY 11790-1320 | 2012-09-21 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| 1922383272 | Jeanne Fitzpatrick | Registered Nurse | 112 Sycamore Cir, Stony Brook, NY 11790-3168 | 2011-10-19 |
| 1679858385 | Michele Lynn Conrad | Registered Nurse | 4 Arlington Ct, Stony Brook, NY 11790-2004 | 2011-10-13 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
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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.