DR. JUSTIN MICHAEL WARYOLD (NPI# 1619148327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619148327 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN MICHAEL WARYOLD |
| Credential | DNP, NP-C |
| Practice Address |
267 E Main St Bldg C Smithtown NY 11787 |
| Mailing Address |
45 Research Way Ste 105 East Setauket NY 11733-6401 |
| Practice Telephone | 6314188069 |
| Practice Fax Number | 6316560470 |
| Mailing Telephone | 6316752125 |
| Mailing Fax Number | 6316752624 |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2018-07-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 542942 | NY | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
304954 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
267 E MAIN ST BLDG C |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518038009 | Ronni Sollazzo | Emergency Medicine | 267 E Main St Bldg C, Smithtown, NY 11787-2847 | 2006-11-13 |
| 1699298588 | Sarah Raziano | Nurse Practitioner | 267 E Main St Bldg C, Smithtown, NY 11787-2847 | 2017-07-23 |
| 1144547522 | Nancy Balkon | Nurse Practitioner | 267 E Main St Bldg C, Smithtown, NY 11787-2847 | 2010-04-26 |
| 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 |
| Find all providers in zip 11787 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346790755 | Catherine Audus | Nurse Practitioner | 60 Lindron Ave, Smithtown, NY 11787-1661 | 2016-10-10 |
| 1891120572 | Jennifer Jane Alfano | Nurse Practitioner | 50 New York 25a, Smithtown, NY 11787 | 2013-09-12 |
| 1003466780 | Heather Caligiuri | Nurse Practitioner | 50 New York Ave # 25a, Smithtown, NY 11787-3448 | 2019-09-16 |
| 1427512763 | Joseph Rosario | Nurse Practitioner | 1056 W Jericho Tpke, Smithtown, NY 11787-3212 | 2019-01-30 |
| 1063917136 | Diane Grassi | Nurse Practitioner | 285 E Main St, Smithtown, NY 11787-2978 | 2018-03-29 |
| 1093238222 | Jaclyn Sara Dimattei | Nurse Practitioner | 75 Landing Meadow Rd, Smithtown, NY 11787-1124 | 2017-07-19 |
| 1699201970 | Beena Jacob | Nurse Practitioner | 285 Middle Country Rd, Smithtown, NY 11787-2978 | 2017-05-05 |
| 1144751934 | Michael Cresson | Nurse Practitioner | 50 New York Ave # 25a, Cardiac Cath Lab, Smithtown, NY 11787-3448 | 2017-03-23 |
| 1164964755 | Ashley Kump | Nurse Practitioner | 1045 W Jericho Tpke, Smithtown, NY 11787-3205 | 2016-11-14 |
| 1447624655 | Kimberly Finnegan | Nurse Practitioner | 50 Route 25a, Smithtown, NY 11787-1348 | 2015-11-25 |
| Find all providers in SMITHTOWN | ||||
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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.