MEDINA ARDOLIC (NPI# 1588217798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588217798 |
| Entity Type | Individual |
| Full Name | MEDINA ARDOLIC |
| Credential | PA |
| Practice Address |
4802 10th Ave Brooklyn NY 11219-2916 |
| Mailing Address |
382 Virginia Ave Staten Island NY 10305-1631 |
| Practice Telephone | 7182838137 |
| Mailing Telephone | 9175256398 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 023454 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4802 10TH AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11219-2916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316943871 | Samantha Paige Jellinek | Pharmacist | 4802 10th Ave, Brooklyn, NY 11219-2844 | 2005-06-21 |
| 1730789959 | Arjun Basnet | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-27 |
| 1679171623 | Shehanaz Shajahan | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-13 |
| 1215534524 | Syed Mohammad Mazhar Uddin | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-08 |
| 1619581899 | Laurel Wright | Psychologist | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-09-03 |
| 1780296749 | Rabiah Ashraf | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-08-20 |
| 1275142820 | Jenna Danae Katherine Kroeker | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-29 |
| 1720696347 | Jay Donald Keith | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-20 |
| 1003424912 | Amit Dhaliwal | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-16 |
| 1912515826 | Supraja Achuthanandan | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073127163 | Chava Bokchin | Registered Nurse | 6200 15th Avenue, Brooklyn, NY 11219 | 2020-09-04 |
| 1164033643 | Debbie Evadne Evans-wright | Nurse Practitioner | 979 48th Street, Brooklyn, NY 11219 | 2020-08-10 |
| 1528614559 | Jonathan Benjamin Goldstein | Specialist | Yeled Vyalda 1312 38 Street, Brooklyn, NY 11219 | 2019-08-15 |
| 1235782301 | Vanessa Walton | Social Worker | 4012 New Utrecht Avenue, Apt 1, Brooklyn, NY 11219 | 2019-07-18 |
| 1083184618 | Sandra Murray | Licensed Practical Nurse | 6321 New Utrecht Avenue Second Floor, Brooklyn, NY 11219 | 2018-11-27 |
| 1023588746 | Wanipa Muwowo-nwade | Physician Assistant | 4802 10th Ave Rm 301, Brooklyn, NY 11219 | 2018-11-26 |
| 1366919896 | Evelin Ponce | Licensed Practical Nurse | 6321 New Utrecht Avenue, Second Floor, Brooklyn, NY 11219 | 2018-11-02 |
| 1083180301 | Yefim Simkhayev | Occupational Therapist | 1317 52nd St, Brooklyn, NY 11219 | 2018-10-15 |
| 1598240186 | F & D Pharmacy Inc | Pharmacy | 5504 -13 Ave, Brooklyn, NY 11219 | 2018-09-28 |
| 1245737469 | Yekaterina Joltikov | Student in an Organized Health Care Education/Training Program | Miamonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219 | 2018-04-13 |
| Find all providers in zip 11219 | ||||
| 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 |
|---|---|---|---|---|
| 1952902256 | Billy Phuoctan Truong | Physician Assistant | 8832 18th Ave, Brooklyn, NY 11214-6002 | 2020-11-03 |
| 1700486560 | Jayanti Rao | Physician Assistant | 1059 Union St Apt 3g, Brooklyn, NY 11225-1268 | 2020-10-29 |
| 1376142737 | Amanda Shinall | Physician Assistant | 28 Old Fulton St Apt 4b, Brooklyn, NY 11201-6909 | 2020-10-18 |
| 1497353825 | Tsz Yan Soo | Physician Assistant | 8825 26th Ave Fl 2, Brooklyn, NY 11214-5408 | 2020-10-16 |
| 1164038907 | Emily Mai | Physician Assistant | 1956 W 9th St, Brooklyn, NY 11223-2548 | 2020-09-17 |
| 1497369342 | Krystal Renee Alexander | Physician Assistant | 2225 Ditmas Ave Apt 1a, Brooklyn, NY 11226-6993 | 2020-09-08 |
| 1578177390 | Celia Chen | Physician Assistant | 2628 E 18th St, Brooklyn, NY 11235-3659 | 2020-08-31 |
| 1669084547 | Peter Forman | Physician Assistant | 86 Saint Felix St, Brooklyn, NY 11217-3032 | 2020-08-20 |
| 1699383646 | Fabienne Mondelus | Physician Assistant | 715 E 108th St Apt 3c, Brooklyn, NY 11236-2929 | 2020-07-15 |
| 1508492729 | Esther Weitzner | Physician Assistant | 1195 E 12th St, Brooklyn, NY 11230-4811 | 2020-03-19 |
| Find all providers in BROOKLYN | ||||
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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.