THREE VILLAGE MEDICAL, PC (NPI# 1588728125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588728125 |
| Entity Type | Organization |
| Organization Name | THREE VILLAGE MEDICAL, PC |
| Practice Address |
207 Hallock Rd Suite 160 Stony Brook NY 11790-3033 |
| Mailing Address |
1890 New York Ave Huntington Station NY 11746-2904 |
| Practice Telephone | 6317515588 |
| Practice Fax Number | 6317515821 |
| Mailing Telephone | 6314276920 |
| Mailing Fax Number | 6314250653 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MATTHEW J VISO (MANAGER) |
| Authorized Official Telephone | 6317515588 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 103139 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
207 HALLOCK RD SUITE 160 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790-3033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851361414 | Peter Smith | Podiatrist | 207 Hallock Rd, Suite 4, Stony Brook, NY 11790-3033 | 2006-01-25 |
| 1720646805 | Samantha Lynn Renieris | Speech-Language Pathologist | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2019-06-03 |
| 1518451459 | Jessica Liberty | Speech-Language Pathologist | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2018-06-14 |
| 1922501964 | Melissa M Schachter | Speech-Language Pathologist | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2018-03-15 |
| 1891217774 | Marisa Massaro | Family Medicine | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2017-07-12 |
| 1497289037 | Stony Brook Oral and Facial Surgery PC | Dentist | 207 Hallock Rd, Suite 2, Stony Brook, NY 11790-3033 | 2017-04-19 |
| 1306394978 | Doughty and Ryzova Medical Group PC | Pediatrics | 207 Hallock Rd, Suite 106, Stony Brook, NY 11790-3033 | 2016-09-13 |
| 1376099226 | Mireille Toughey | Registered Nurse | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2016-08-31 |
| 1518360197 | Marianne Kaminski | Registered Nurse | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2014-09-26 |
| 1962803163 | Dianne Munnich | Registered Nurse | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2014-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619402385 | Rajbir S Tanda | Internal Medicine | Stony Brook Ufpc Sbumc Hsc Level 16 Room 20, Stony Brook, NY 11794-1256 | 2017-05-01 |
| 1740712751 | Nicole Marie Lum | Internal Medicine | Suny Stony Brook Hospital 101 Nicolls Rd, Dept. of Medicine, Hsc Level 16, Stony Brook, NY 11794-0001 | 2017-03-29 |
| 1538612403 | Afzal Mohammed Sheikh | Internal Medicine | 101 Nicolls Rd # T16-020, Stony Brook, NY 11794-0001 | 2016-07-27 |
| 1447607171 | Chao-wei Tsai | Internal Medicine | 101 Nicolls Rd # Hscl3045, Stony Brook, NY 11794-0001 | 2016-05-23 |
| 1588028534 | Zalak Desai | Internal Medicine | 101 Nicolls Road, Deptartment of Medicine, Hsc Level 16, Room 020, Stony Brook, NY 11794-8160 | 2016-04-06 |
| 1972980647 | Grace Boluwape Olowo | Internal Medicine | Hsc L2-144, Stony Brook, NY 11794 | 2015-05-01 |
| 1467849067 | Charles Ramkishun | Internal Medicine | Dept. of Medicine, Hsc Level 16, Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2015-04-21 |
| 1194112235 | Elixabeth Laskurain Sullivan | Internal Medicine | Dept of Medicine Hsc Level 16 Suny Stony, Stony Brook, NY 11794-0001 | 2015-04-15 |
| 1063808921 | Venu Pasricha | Internal Medicine | Stony Brook University Medical Center Hsc T 17-040, Stony Brook, NY 11794-0001 | 2015-04-07 |
| 1225448715 | Lorenzo Ottaviano | Internal Medicine | Dept of Medicine Hsc Level 16 020, Suny Stony Brook Hospital, Stony Brook, NY 11794-0001 | 2014-05-06 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11790 |
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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.