ALEXIS NICOLE MANZ (NPI# 1649894338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649894338 |
Entity Type | Individual |
Full Name | ALEXIS NICOLE MANZ |
Credential | PA |
Practice Address |
1200 Route 300 Newburgh NY 12550-5003 |
Mailing Address |
155 Crystal Run Rd Middletown NY 10941-4028 |
Practice Telephone | 8457036999 |
Practice Fax Number | 8457036297 |
Mailing Telephone | 8457036999 |
Mailing Fax Number | 8457036297 |
Enumeration Date | 2020-05-29 |
Last Update Date | 2020-10-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
024834 | NY | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1200 ROUTE 300 |
City | NEWBURGH |
State | NY |
Zip Code | 12550-5003 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316917990 | Eileen Gayle Bogursky | Obstetrics & Gynecology | 1200 Route 300, Newburgh, NY 12550-5003 | 2006-01-25 |
1134643075 | Michelle Newell-whitney | Nurse Practitioner | 1200 Route 300, Newburgh, NY 12550-5003 | 2017-08-02 |
1831610369 | Mandi L. Zaccagnino | Nurse Practitioner | 1200 Route 300, Newburgh, NY 12550-5003 | 2017-07-06 |
1790137743 | Tiffanie R. Santos | Pediatrics | 1200 Route 300, Newburgh, NY 12550-5003 | 2016-07-01 |
1356796312 | Megan Elizabeth Kaknis | Internal Medicine | 1200 Route 300, Newburgh, NY 12550-5003 | 2016-04-27 |
1053780403 | Crystal Run Healthcare Physicians LLP | Durable Medical Equipment & Medical Supplies | 1200 Route 300, Newburgh, NY 12550-5003 | 2015-09-16 |
1104207893 | Theresa Marie Clearwater | Nurse Practitioner | 1200 Route 300, Newburgh, NY 12550-5003 | 2015-06-18 |
1063807980 | Sebastian Salvatore Demarco | Dermatology | 1200 Route 300, Newburgh, NY 12550-5003 | 2015-03-30 |
1871993642 | Veronica Ferencz | Surgery | 1200 Route 300, Crystal Run Healthcare- Breast Surgery, Newburgh, NY 12550 | 2014-08-29 |
1174962971 | Bernadette Sikes Wood | Internal Medicine | 1200 Route 300, Newburgh, NY 12550-5003 | 2013-06-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154986057 | Jennifer Lauren Steckenrider | Optometrist | 1201 Ny-300, Newburgh, NY 12550 | 2019-05-06 |
1386103125 | Dorian Kim Shann | Physical Therapist | 53 Ny-17k Suite 2, Newburgh, NY 12550 | 2019-03-19 |
1083186100 | Kimberly Ellen Vondras | Registered Nurse | 21-23 Grand Street, Newburgh, NY 12550 | 2018-12-31 |
1487144887 | Jenna Gaudio | Dentist | 1413 Union Ave, Newburgh, NY 12550 | 2018-05-11 |
1215431119 | Diane Gonzales | Counselor | 3 Commercial Place, Newburgh, NY 12550 | 2018-03-23 |
1386148740 | Cvs Albany LLC | Pharmacy | 203 South Plank Rd, Newburgh, NY 12550 | 2018-03-21 |
1063939510 | Paula A. Coloni | Social Worker | One Maguire Way Stewart Air National Guard Base, Newburgh, NY 12550 | 2017-08-25 |
1306362652 | Richard Malvey | Counselor | 172 Liberty Street, Newburgh, NY 12550 | 2017-08-18 |
1770008559 | Walgreen Co | Pharmacy | 59 N Plank Rd Ste 2, Newburgh, NY 12550 | 2017-08-14 |
1639691017 | Danielle Elizabeth Ingrassia | Behavioral Analyst | 8 Crestwood Ct., Newburgh, NY 12550 | 2017-07-07 |
Find all providers in zip 12550 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689785156 | Phyllis Young | Physician Assistant | 254 Route 17k, Suite 203, Newburgh, NY 12550-8343 | 2006-08-31 |
1225042344 | Julie C Ormiston | Physician Assistant | 308 Fullerton Ave, Newburgh, NY 12550-3722 | 2006-07-27 |
1225014210 | Thomas W Waters | Physician Assistant | 5911 Laurel Ridge Dr, Newburgh, IN 47630-8067 | 2005-12-21 |
1669019675 | Kayley Mae Spinella | Physician Assistant | 147 Lake St, Newburgh, NY 12550-5263 | 2019-12-09 |
1740762673 | Elizabeth Conkling | Physician Assistant | 100 St Marys Epworth Xing Ste B100, Newburgh, IN 47630-9161 | 2018-09-06 |
1083120273 | Brianna Miller | Physician Assistant | 100 St Marys Epworth Xing Ste B100, Newburgh, IN 47630-9161 | 2017-12-26 |
1457870289 | Stephanie Marie Kramer | Physician Assistant | 200 Stony Brook Ct, Newburgh, NY 12550 | 2017-09-13 |
1487182283 | Ethan Levine | Physician Assistant | 70 Dubois St, Newburgh, NY 12550-4851 | 2017-05-24 |
1497202964 | Lindsey Alt | Physician Assistant | 147 Lake St, Newburgh, NY 12550 | 2016-09-01 |
1962888248 | Kirstin A Tarquini | Physician Assistant | 147 Lake St, Newburgh, NY 12550-5263 | 2015-08-10 |
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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.