MARK J. ZUCKERMAN, PHYSICIAN, P.C. (NPI# 1598909780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598909780 |
| Entity Type | Organization |
| Organization Name | MARK J. ZUCKERMAN, PHYSICIAN, P.C. |
| Practice Address |
363 Route 111 Suite 102 Smithtown NY 11787-4756 |
| Mailing Address |
373 Route 111 Suite 20 Smithtown NY 11787-4759 |
| Practice Telephone | 6313603366 |
| Practice Fax Number | 6313603380 |
| Mailing Telephone | 6313603366 |
| Mailing Fax Number | 6313603380 |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2015-06-01 |
| Authorized Official Name | MARK J. ZUCKERMAN (PHYSICIAN) |
| Authorized Official Telephone | 6313603366 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
171222 | NY | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MARK J. ZUCKERMAN, PHYSICIAN, P.C. | 363 Route 111, #102, Smithtown, Ny 11787 |
| Street Address |
363 ROUTE 111 SUITE 102 |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-4756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740242585 | Valerie Jessen | Social Worker | 363 Route 111, Suite 103, Smithtown, NY 11787-4756 | 2006-04-05 |
| 1194337253 | Eva Dziergowska | Nurse Practitioner | 363 Route 111, Smithtown, NY 11787-4756 | 2020-08-20 |
| 1851815716 | Timothy Patrick Aiello | Nurse Practitioner | 363 Route 111, Smithtown, NY 11787-4756 | 2017-08-01 |
| 1396295853 | Katie Anne Goehle | Social Worker | 363 Route 111, Suite 103, Smithtown, NY 11787-4756 | 2016-10-09 |
| 1700331873 | Pamela Trifaro, Lcsw, Pllc | Social Worker | 363 Route 111, Suite 103, Smithtown, NY 11787-4756 | 2016-08-18 |
| 1336517242 | Long Island Medical Office, Pllc | Physical Medicine & Rehabilitation | 363 Route 111, Suite 107b, Smithtown, NY 11787-4756 | 2015-09-09 |
| 1932516911 | Gateway Counseling Lcsw Pllc | Social Worker | 363 Route 111, Suite 103, Smithtown, NY 11787-4750 | 2014-07-22 |
| 1174896021 | Matthew D Gee, Lcsw, Phd, LLC | Social Worker | 363 Route 111, Suite 103, Smithtown, NY 11787-4756 | 2012-02-22 |
| 1538431275 | Shannon King | Acupuncturist | 363 Route 111, Suite Ll8, Smithtown, NY 11787-4756 | 2012-01-26 |
| 1225325194 | Osteo Relief of Long Island PC | Physical Medicine & Rehabilitation | 363 Route 111, Suite 107, Smithtown, NY 11787-4756 | 2011-06-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
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| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255499406 | Harpreet Khurana | Psychiatry & Neurology | 496 Smithtown Bypass, Suite 307, Smithtown, NY 11787-5012 | 2006-12-04 |
| 1467556662 | Schenley H Que | Psychiatry & Neurology | 45 Terry Road, Suite A, Smithtown, NY 11787 | 2006-09-11 |
| 1497392617 | Dr. Jennifer Mcmonigle Medical, P.C. | Psychiatry & Neurology | 1045 W Jericho Tpke, Smithtown, NY 11787-3205 | 2019-12-06 |
| 1033458526 | Reuben David Burshtein | Psychiatry & Neurology | 45 Terry Rd, Ste A, Smithtown, NY 11787-3894 | 2013-02-05 |
| 1912163346 | Mathew M. Chacko Physician PC | Psychiatry & Neurology | 222 E Main St, Suite 101, Smithtown, NY 11787-2871 | 2008-08-05 |
| 1821256595 | Island Comprehensive Neurology LLP | Psychiatry & Neurology | 496 Smithtown Byp, Suite 307, Smithtown, NY 11787-5005 | 2008-05-29 |
| 1790846244 | Mark Julian Zuckerman | Psychiatry & Neurology | 373 Route 111, Suite 20, Smithtown, NY 11787-4759 | 2006-12-12 |
| 1407956907 | Mathew Meloottu Chacko | Psychiatry & Neurology | 222 E Main St, Siute 101, Smithtown, NY 11787-2871 | 2006-09-24 |
| 1376647578 | Richard A Pearl Md PC | Psychiatry & Neurology | 45 Terry Road, Suite A, Smithtown, NY 11787 | 2006-09-11 |
| 1740384932 | Richard A Pearl | Psychiatry & Neurology | 45 Terry Road, Suite A, Smithtown, NY 11787 | 2006-09-11 |
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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.