J ANDREW FANTL GYNECOLOGY PC (NPI# 1679653448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679653448 |
| Entity Type | Organization |
| Organization Name | J ANDREW FANTL GYNECOLOGY PC |
| Practice Address |
222 Middle Country Rd Suite 203 Smithtown NY 11787 |
| Practice Telephone | 6319792842 |
| Practice Fax Number | 6319792845 |
| Mailing Telephone | 6319792842 |
| Mailing Fax Number | 6319792845 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2008-05-13 |
| Authorized Official Name | DR. JOHN ANDREW FANTL (DOCTOR PRESIDENT) |
| Authorized Official Telephone | 6319792842 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
1988811 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OXFORD | P1935301 | 01 | |
| MULTIPLAN | P62326327 | 01 | |
| HIP | 198881 | 01 | |
| VYTRA | 53073 | 01 | |
| CIGNA | 5817720 | 01 | |
| BCBS | 665C41 | 01 | |
| GHI | 9658042 | 01 | |
| MDNY | AA50860 | 01 |
| Street Address |
222 MIDDLE COUNTRY RD SUITE 203 |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225021132 | Adi Zion | Physical Therapist | 222 Middle Country Rd, Suite 105, Smithtown, NY 11787-2871 | 2005-08-25 |
| 1134492945 | Michael Domenick Damico | Dentist | 222 Middle Country Rd, Suite 316, Smithtown, NY 11787-2871 | 2012-02-10 |
| 1730408923 | Physicians Private Practice, Pllc | Internal Medicine | 222 Middle Country Rd, Suite 103, Smithtown, NY 11787-2871 | 2010-05-27 |
| 1346484615 | Carol Diane Vogel | Physical Therapist | 222 Middle Country Rd, Suite 105, Smithtown, NY 11787-2871 | 2009-04-29 |
| 1235377276 | Martha Tsarkalis | Family Medicine | 222 Middle Country Rd, Suite 103, Smithtown, NY 11787-2871 | 2009-01-29 |
| 1386828861 | Mark Tan, M.d., P.C. | Specialist | 222 Middle Country Rd, Suite # 312, Smithtown, NY 11787 | 2007-12-20 |
| 1154513117 | Johanna Petrycki | Physician Assistant | 222 Middle Country Rd, Suite 228, Smithtown, NY 11787-2871 | 2007-08-14 |
| 1558489864 | North Shore Psychiatric Consultants PC | Psychiatry & Neurology | 222 Middle Country Rd, Suite 210, Smithtown, NY 11787-2814 | 2007-03-26 |
| 1255407987 | Shelley J Epstein | Psychiatry & Neurology | 222 Middle Country Rd, Suite 210, Smithtown, NY 11787-2814 | 2006-11-27 |
| 1407929003 | Robert S Castroll | Psychiatry & Neurology | 222 Middle Country Rd, Suite 210, Smithtown, NY 11787-2814 | 2006-11-15 |
| Find all providers in the same location | ||||
| 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 | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881784817 | Frank S Bonura | Obstetrics & Gynecology | 48 Rte 25a, Smithtown, NY 11787-1431 | 2006-10-13 |
| 1467560763 | David Michael Shobin | Obstetrics & Gynecology | 498 Rt 11, Smithtown, NY 11787-4732 | 2006-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370975 | Legacy Gynecology Pllc | Obstetrics & Gynecology | 136 Maple Rd, Amherst, NY 14221-2922 | 2020-09-11 |
| 1700494143 | Neighborhood Family Medicine | Obstetrics & Gynecology | 50 Front St, Binghamton, NY 13905-4708 | 2020-07-22 |
| 1467070029 | Electra Health Medical PC | Obstetrics & Gynecology | 335 Madison Ave Fl 3, New York, NY 10017-4616 | 2020-07-10 |
| 1164048021 | Park East Medical Pllc | Obstetrics & Gynecology | 870 5th Ave Apt 1b, New York, NY 10065-4907 | 2020-06-17 |
| 1497391486 | Central Park Gyn | Obstetrics & Gynecology | 233 W 58th Street, New York, NY 10019 | 2019-11-25 |
| 1861955858 | New H Medical, P.C. | Obstetrics & Gynecology | 1150 Park Ave Ste 1a, New York, NY 10128-1244 | 2019-04-08 |
| 1851857379 | Broadway Gyn Office, P.c | Obstetrics & Gynecology | 4915 Broadway # 1-k, New York, NY 10034-3119 | 2019-02-20 |
| 1841755063 | Elizabeth Anne Mancuso | Obstetrics & Gynecology | 3 E 69th St, New York, NY 10021-5249 | 2019-02-01 |
| 1699239251 | Gynecology and Integrative Women's Care | Obstetrics & Gynecology | 30 E 23rd St Fl 7, New York, NY 10010-4440 | 2019-01-29 |
| 1699248542 | Great Wall Medical, P.C. | Obstetrics & Gynecology | 201e 28th Street, Suite #1b, New York, NY 10016 | 2019-01-03 |
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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.