JOHN CHARLES MUTZIGER JR. (NPI# 1578105904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578105904 |
| Entity Type | Individual |
| Full Name | JOHN CHARLES MUTZIGER JR. |
| Practice Address |
939 Johnson Ave Ronkonkoma NY 11779-6066 |
| Mailing Address |
50 Davis Ave Blue Point NY 11715-1609 |
| Practice Telephone | 6313694418 |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
009131-1 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528041639 | John C. Mutziger I | Family Medicine | 14884 Hwy 15, Decatur, MS 39327 | 2005-11-22 |
| Street Address |
939 JOHNSON AVE |
| City | RONKONKOMA |
| State | NY |
| Zip Code | 11779-6066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578516738 | Association for Mental Health and Wellness Inc | Case Management | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2006-05-18 |
| 1154941797 | Brianna Oliveri | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-23 |
| 1861021230 | Christina Wieczorek | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-07 |
| 1336778703 | Linda S Rosasco | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-07 |
| 1154950525 | Keira Conrad | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-07 |
| 1366071730 | Stephen John Boose | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-07 |
| 1376179630 | Michael Baptiste | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-03-19 |
| 1356974299 | Dominique Nicole Zummo | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-02-19 |
| 1891338638 | Jillian Sarah Aiello | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2019-10-24 |
| 1578114567 | Casey Ellen Lamarca | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779 | 2019-09-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265736482 | Suzanne Marie Edelman | Counselor | 939 Johnson Avenue, Ronkonkoma, NY 11779-6066 | 2011-01-03 |
| 1629571534 | Brigette Kremens | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2018-03-16 |
| 1447790233 | Toni Kumar | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2017-02-28 |
| 1912447772 | Christina Marie Steudte | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2017-02-27 |
| 1841741394 | Jennifer Gutkes | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2016-10-19 |
| 1346671575 | Christine Plante | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2013-12-13 |
| 1760737613 | Laura Marie Schlageter | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2012-07-17 |
| 1396002010 | James Thomas Lahey I | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2012-04-19 |
| 1154631034 | Megan Kathleen Arkinson | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2010-10-13 |
| 1669780995 | Yaritza Gomez-nacht | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2010-09-21 |
| Find all providers in RONKONKOMA | ||||
| City | RONKONKOMA |
| Zip Code | 11779 |
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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.