ANGELO R. DEROSALIA (NPI# 1649444183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649444183 |
| Entity Type | Individual |
| Full Name | ANGELO R. DEROSALIA |
| Credential | MD |
| Practice Address |
5100 W Taft Rd Suite 4d Liverpool NY 13088-3807 |
| Mailing Address |
1226 E Water St Syracuse NY 13210-1155 |
| Practice Telephone | 3154586669 |
| Practice Fax Number | 3154580819 |
| Mailing Telephone | 3154784185 |
| Mailing Fax Number | 3154780840 |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2012-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 244397 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
5100 W TAFT RD SUITE 4D |
| City | LIVERPOOL |
| State | NY |
| Zip Code | 13088-3807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023015500 | Jody S Bleier | Internal Medicine | 5100 W Taft Rd, Suite 4j, Liverpool, NY 13088-3807 | 2005-06-30 |
| 1528620812 | Colleen Byrnes | Nurse Practitioner | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2019-07-08 |
| 1851866727 | Kathryn Quinn Manion | Clinic/Center | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-10-08 |
| 1225514623 | Shannon M Roach | Nurse Practitioner | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-07-18 |
| 1497263826 | Kimberly Cleary | Registered Nurse | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-01-19 |
| 1184077885 | Maia Czarnecki | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2016-07-18 |
| 1174974216 | Jenna Marie Laskey | Family Medicine | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2016-06-30 |
| 1669838108 | Phitsamai Thatvihane | Nurse Practitioner | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2016-01-14 |
| 1992160188 | Melissa Buttner | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2015-12-15 |
| 1538532940 | Chelsey Brooks | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2015-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878966 | Anthony Edward Blumetti | Psychologist | 5100 W. Taft Road, Suite 3b, Liverpool, NY 13088 | 2019-12-12 |
| 1609350016 | Alice Nellenbach | Physical Therapy Assistant | 346 Electronics Pkwy, Liverpool, NY 13088 | 2018-09-20 |
| 1043741457 | Dawn Marie Thomas | Licensed Practical Nurse | 212 Old Liverpool Road, Building 7 Apartment 6, Liverpool, NY 13088 | 2017-03-27 |
| 1154775633 | Arielle L Leonard | Massage Therapist | 609 7th N. Street, Suite 2, Liverpool, NY 13088 | 2016-04-20 |
| 1942664362 | Accessibility Solutions, Inc. | Contractor | 115 Luther Avenue, Liverpool, NY 13088 | 2016-04-12 |
| 1497176333 | Sergey Golovko | Psychiatry & Neurology | 125 Sun Harbor Dr, Liverpool, NY 13088 | 2013-12-19 |
| 1205275286 | Brandon William Crandall | Nurse Practitioner | 5100 West Taft Rd., Suite 1c, Liverpool, NY 13088 | 2013-06-23 |
| 1184976805 | Audrey Irene Tyszka | Social Worker | 5100 W Taft Rd Ste 1f, Liverpool, NY 13088 | 2012-10-04 |
| 1790049096 | Kelley Beth Burt | Speech-Language Pathologist | 110 Elwood Davis Road, Liverpool, NY 13088 | 2012-07-02 |
| 1811288954 | Nedim Ruhotina | Urology | 100 Metropolitan Park Drive, Suite 100, Liverpool, NY 13088 | 2011-04-24 |
| Find all providers in zip 13088 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811288954 | Nedim Ruhotina | Urology | 100 Metropolitan Park Drive, Suite 100, Liverpool, NY 13088 | 2011-04-24 |
| 1740429869 | Arnold P Teo | Urology | 100 Metropolitan Park Dr, Suite 100, Liverpool, NY 13088-5841 | 2009-02-12 |
| 1023312121 | Associated Medical Professionals of Ny, Pllc | Urology | 8100 Oswego Rd, Liverpool, NY 13090-1654 | 2011-01-04 |
| 1518130863 | Associated Medical Professionals of Ny, Pllc | Urology | 5100 W Taft Rd, Suite 4d, Liverpool, NY 13088-3807 | 2008-04-08 |
| 1366535833 | Alicia Rose Castrello | Urology | 7246 Janus Park Dr, Liverpool, NY 13088-4839 | 2006-10-02 |
| 1518915040 | Elan W Salzhauer | Urology | 5100 W Taft Rd, Suite 4-d, Liverpool, NY 13088-3807 | 2006-05-05 |
| 1033185251 | Patricia J Szymanowski | Urology | 5100 W Taft Rd, Suite 4-d, Liverpool, NY 13088 | 2006-02-27 |
| 1124094776 | Sanford P Temes | Urology | 5100 W Taft Rd, Stuite 4-d, Liverpool, NY 13088-3807 | 2006-02-24 |
| 1720052558 | William H Roberts | Urology | 5100 W Taft Rd, Suite 4-d, Liverpool, NY 13088-3807 | 2006-02-16 |
| 1558335463 | Michael J Kendrick | Urology | 5100 W Taft Rd, Suite 4 D, Liverpool, NY 13088 | 2006-02-15 |
| Find all providers in LIVERPOOL | ||||
Please comment or provide details below to improve the information on ANGELO R. DEROSALIA.
| 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.