MS. QUDTIA GALLISHAW (NPI# 1659668002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659668002 |
| Entity Type | Individual |
| Full Name | MS. QUDTIA GALLISHAW |
| Other Name | N/A N/A N/A |
| Credential | RN |
| Practice Address |
136 Henderson Blvd Syracuse NY 13209-1856 |
| Practice Telephone | 3153035452 |
| Mailing Telephone | 3153035452 |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-06-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
749031 | NY | Nursing Service Providers |
| N | 164W00000X | Licensed Practical Nurse | 267829 | NY | Nursing Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3155 Riverknoll Dr North, Apt 208, Baldwinsville, NY 13027 | 3153035452 |
| Street Address |
136 HENDERSON BLVD |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13209-1856 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669938676 | Tammy Theresa Lamanna | Licensed Practical Nurse | 313 Snowdale Drive, Syracuse, NY 13209 | 2019-02-14 |
| 1306313531 | Kseniya Alekseyevna Lueck | Student in an Organized Health Care Education/Training Program | 890 State Fair Blvd, Syracuse, NY 13209 | 2018-10-25 |
| 1699051144 | Cheryl L. Birkmier | Speech-Language Pathologist | 600 Gertrude Ave., Solvay High School, Solvay, NY 13209 | 2011-10-28 |
| 1346564085 | Kathy Smith | Licensed Practical Nurse | 126 Hosmer Drive, Syracuse, NY 13209 | 2010-03-24 |
| 1417103771 | Susan Tina Waldt | Licensed Practical Nurse | 512 Rosewood Road, Syracuse, NY 13209 | 2008-08-18 |
| 1932288222 | West Side Physical Therapy, PC | Clinic/Center | 315 Bridge St, Solvay, NY 13209 | 2006-11-06 |
| 1912099821 | Suzanne M Skibinski | Physical Therapist | 315 Bridge St, Solvay, NY 13209 | 2006-09-28 |
| 1336231240 | Debra Ann Donohue | Physical Therapist | 315 Bridge St, Solvay, NY 13209 | 2006-09-28 |
| 1669564589 | Caryn Lindsay Baker | Physical Therapist | 315 Bridge St, Solvay, NY 13209 | 2006-09-28 |
| 1982872669 | Medisource Management, LLC | Durable Medical Equipment & Medical Supplies | 145 Dwight Park Cir, Syracuse, NY 13209-1005 | 2008-02-14 |
| Find all providers in zip 13209 | ||||
| Taxonomy Code | 163WM0705X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Medical-Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225395809 | Lisa Cardinale | Registered Nurse | 230 W Willow St, 406, Syracuse, NY 13202-1026 | 2012-04-19 |
| 1083254197 | Chelsea Parkes | Registered Nurse | 301 Prospect Ave, Syracuse, NY 13203-1807 | 2020-01-07 |
| 1336784479 | Wendy Sue Colt | Registered Nurse | 800 Irving Ave, Syracuse, NY 13210-2716 | 2019-11-13 |
| 1932520368 | Michele Jacqueline Stowell | Registered Nurse | 800 Irving Ave, Syracuse, NY 13210-2716 | 2014-01-03 |
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|---|---|---|---|---|
| 1730787631 | Shinelle Burgess | Registered Nurse | 287 N 3rd Ave, Bay Shore, NY 11706-4109 | 2020-10-13 |
| 1881201812 | Merlyn Hope Bennett | Registered Nurse | 19726 Carpenter Ave, Hollis, NY 11423-2959 | 2020-09-24 |
| 1033723119 | Louise Margarrette Lazol | Registered Nurse | 362 Parkside Ave, Brooklyn, NY 11226-1480 | 2020-09-04 |
| 1013521129 | Eliana Shinefield | Registered Nurse | 520 W 184th St Apt 42, New York, NY 10033-4353 | 2020-09-04 |
| 1710591292 | Suzanne Soltani | Registered Nurse | 6 Harriet Ct, Sea Cliff, NY 11579-1419 | 2020-09-02 |
| 1790397446 | Chaunte West | Registered Nurse | 98 Spaulding St, Buffalo, NY 14220-1238 | 2020-08-22 |
| 1023627288 | Nikkita Jackson | Registered Nurse | 454 Westchester Avenue, Port Chester, NY 10573 | 2020-07-23 |
| 1154946663 | Schnell Ewart Fowles | Registered Nurse | 14742 109th Ave, Jamaica, NY 11435-5416 | 2020-06-10 |
| 1295359057 | Amenda Almonte | Registered Nurse | 15804 Sanford Ave Apt 2a, Flushing, NY 11358-2532 | 2020-06-07 |
| 1982228979 | Christine Egeria Mouzakitis | Registered Nurse | 12 Vinton St, North Massapequa, NY 11758-1030 | 2020-06-04 |
| Find all providers with the same taxonomy | ||||
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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.