DOMICIANO PATACSIL (NPI# 1649209735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649209735 |
| Entity Type | Individual |
| Full Name | DOMICIANO PATACSIL |
| Credential | MD |
| Practice Address |
400 Patroon Creek Blvd Suite 101 Albany NY 12206 |
| Practice Telephone | 5184358360 |
| Practice Fax Number | 5184358391 |
| Mailing Telephone | 5184358360 |
| Mailing Fax Number | 5184358391 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2008-03-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 134434 | NY | Allopathic & Osteopathic Physicians |
| Y | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
134434 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01332067 | 05 |
| Street Address |
400 PATROON CREEK BLVD SUITE 101 |
| City | ALBANY |
| State | NY |
| Zip Code | 12206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881691053 | Siobhan Kuhar | Otolaryngology | 400 Patroon Creek Blvd, Suite 205, Albany, NY 12206-5013 | 2005-07-03 |
| 1083168603 | St. Peter's Health Partners Medical Associates, PC | Emergency Medicine | 400 Patroon Creek Blvd, Suite 100, Albany, NY 12206-5013 | 2016-08-11 |
| 1386010056 | Dara Kelly | Audiologist | 400 Patroon Creek Blvd, Suite 205, Albany, NY 12206-5013 | 2015-08-18 |
| 1457737280 | Amanda Dipierro | Nurse Practitioner | 400 Patroon Creek Blvd, Suite 1, Albany, NY 12206-5013 | 2015-08-04 |
| 1548674278 | Randi Daniels | Nurse Practitioner | 400 Patroon Creek Blvd, Suite 1, Albany, NY 12206-5013 | 2014-06-20 |
| 1285047423 | Albany Advanced Imaging Pllc | Radiology | 400 Patroon Creek Blvd, Suite 100, Albany, NY 12206-5013 | 2014-06-05 |
| 1285047746 | Robert Freeman | Family Medicine | 400 Patroon Creek Blvd, Albany, NY 12206-5013 | 2014-06-03 |
| 1952720476 | Albany Medical College | Psychiatry & Neurology | 400 Patroon Creek Blvd, Suite 210, Albany, NY 12206-5013 | 2014-04-11 |
| 1144648817 | Mary Ellen Rinaldi | Pharmacist | 400 Patroon Creek Blvd, Suite 200, Albany, NY 12206-5013 | 2014-03-31 |
| 1326466244 | New York Oncology Hematology PC | Non-Pharmacy Dispensing Site | 400 Patroon Creek Blvd, Suite 1, Albany, NY 12206-5013 | 2014-03-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144749854 | Madena Lynn Henderson | Licensed Practical Nurse | 51 Garfield Pl, Albany, NY 12206 | 2017-09-13 |
| 1912456534 | Adeel A Janjua I | Contractor | 17 Roosevelt St, Albany, NY 12206 | 2016-09-23 |
| 1376901595 | Jacqueline Aimee Dall | Nurse Practitioner | 855 Central Avenue, Albany, NY 12206 | 2016-02-02 |
| 1326414210 | Sarah Walton | Pharmacist | 346 Central Ave, Albany, NY 12206 | 2015-08-14 |
| 1376932558 | Hope House, Inc. | Substance Abuse Rehabilitation Facility | 577 Livingston Ave., Albany, NY 12206 | 2015-01-12 |
| 1679993828 | Lori S. Matulewicz | Nurse Practitioner | 500 Central Ave., Equinox, Inc., Albany, NY 12206 | 2014-04-25 |
| 1437417995 | Ernest Nicola Chisena | Orthopaedic Surgery | 1367 Washington Avenue Suite 200, Albany, NY 12206 | 2012-05-02 |
| 1629368519 | Joseph M Rozell | Radiology | 255 Patroon Creek Blvd Apt 3439, Albany, NY 12206 | 2011-04-12 |
| 1346542404 | Melissa June Kowlessar | Licensed Practical Nurse | 69 Benson Street, Albany, NY 12206 | 2010-11-23 |
| 1316109796 | Edmund John Mcgrath | Podiatrist | 911 Central Avenue #24, Albany, NY 12206 | 2008-06-27 |
| Find all providers in zip 12206 | ||||
| Taxonomy Code | 207ZP0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649536012 | Yue Sun | Pathology | 47 New Scotland Ave # Mc81, Albany, NY 12208-3412 | 2012-04-10 |
| 1124486329 | Albany Medical College | Pathology | 47 New Scotland Ave, Albany, NY 12208-3412 | 2016-02-02 |
| 1760618904 | Affiliated Pathology Lab | Pathology | 47 New Scotland Ave, Albany, NY 12208-3412 | 2009-06-02 |
| 1376733311 | Lilia Koshnitsky | Pathology | 400 Patroon Creek Blvd, Suite 101, Albany, NY 12206 | 2007-07-26 |
| 1790775120 | Jiang Qian | Pathology | 47 New Scotland Ave, Albany, NY 12208-3412 | 2005-10-26 |
| 1205826856 | Timothy Jennings | Pathology | 47 New Scotland Ave, Albany, NY 12208-3412 | 2005-10-25 |
| 1336139930 | Anna Boguniewicz | Pathology | 47 New Scotland Ave, Albany, NY 12208-3412 | 2005-10-25 |
| 1689664294 | John Carlson | Pathology | 47 New Scotland Ave, Albany, NY 12208-3412 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225649445 | Ben Bristol | Pathology | 424 Manville Rd Apt 2, Pleasantville, NY 10570-2848 | 2020-08-11 |
| 1548879802 | Vanguard Medical Services Pllc | Pathology | 233 Broadway Rm 2750, New York, NY 10279-2704 | 2020-07-23 |
| 1376164541 | Iftikhar Butt | Pathology | 17 Stablegate Dr, Clifton Park, NY 12065-6796 | 2020-04-29 |
| 1699395392 | Farah Malek | Pathology | 51 Heritage Point Drvie, Clifton Park, NY 12065 | 2020-04-22 |
| 1902436728 | Coney Island Medical Diagnostic Services P C | Pathology | 1704 Mermaid Ave Ste 6, Brooklyn, NY 11224-2622 | 2020-01-21 |
| 1821527680 | Gamaliel Immanuel Medical Services PC | Pathology | 230 Hilton Ave Ste 214, Hempstead, NY 11550-8116 | 2017-06-06 |
| 1639605991 | New York Medical and Diagnostic Services PC | Pathology | 2315 86th St Fl 1, Brooklyn, NY 11214-4309 | 2017-05-05 |
| 1902355415 | Jayne Elizabeth Kremzier | Pathology | 349 Reist St, Williamsville, NY 14221-5344 | 2016-09-26 |
| 1336509090 | Joseph C Segen | Pathology | 1 Hawthorne Ln, Manhasset, NY 11030-1505 | 2016-02-24 |
| 1386061133 | Lee J. Slavutin | Pathology | 100 Riverside Drive, Apt 15d, New York, NY 10024 | 2014-03-18 |
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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.