JEAN MARIE ANDERSON (NPI# 1750475315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750475315 |
| Entity Type | Individual |
| Full Name | JEAN MARIE ANDERSON |
| Credential | RD, CDN,CDE,MS |
| Practice Address |
79 Middleville Rd Northport NY 11768-2200 |
| Practice Telephone | 6312614400 |
| Practice Fax Number | 6312666018 |
| Mailing Telephone | 6312614400 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2009-11-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 805573 | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | CERTIFIED DIETITIAN-NUTRI | 000570-1 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366824096 | Jean Anderson | Psychologist | 552 Fagaima Road, Pago Pago, AS 96799 | 2015-06-18 |
| 1285868091 | Jean Diciancia Anderson | Physical Therapist | 200 Kennedy Memorial Drive, Rehab Works Dept., Waterville, ME 04901 | 2009-05-07 |
| 1861681272 | Jean Figuli Anderson | Specialist/Technologist | Cmr 415 Box 4246, Apo, AE 09114-0043 | 2007-10-22 |
| 1285821967 | Jean Marie Anderson | Physical Therapist | 6671a Wildwood Dr, Fort Drum, NY 13603-2053 | 2007-09-26 |
| 1285731679 | Jean Ellen Anderson | Dental Hygienist | 1789 Woodlane Drive, Suite D, Woodbury, MN 55125 | 2006-09-20 |
| 1861819278 | Jean L. Anderson | Social Worker | 9333 E 21st St N, Wichita, KS 67206-2927 | 2014-03-24 |
| 1518242064 | Jean Anderson | Nurse Practitioner | 2251 Connecticut Ave S, Sartell, MN 56377-2486 | 2011-10-17 |
| 1740599372 | Jean Ann Anderson | Dietitian, Registered | 214 S. Fourth St., Kremmling, CO 80459 | 2010-09-30 |
| 1417185190 | Jean Anderson | Registered Nurse | 421 Sw Oak St, #210, Portland, OR 97204-1817 | 2009-07-01 |
| 1376694349 | Jean A Anderson | Nurse Practitioner | 201 North Washington Street, Falls Church, VA 22046 | 2007-01-16 |
| Street Address |
79 MIDDLEVILLE RD |
| City | NORTHPORT |
| State | NY |
| Zip Code | 11768-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417958471 | David Wayne Gately | Psychologist | 79 Middleville Rd, Va Medical Center, Psychology Service (116b), Northport, NY 11768-2200 | 2005-08-02 |
| 1497356174 | Cynthia Abigail Serrano-colon | Nurse Practitioner | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-11-08 |
| 1225636020 | Jessie Ryan Poznack | Pathology | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-10-14 |
| 1356958094 | Alex Myunghwan Shin | Optometrist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-09-27 |
| 1407460470 | Kimberly Ann Smith | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-09-07 |
| 1790398634 | Simrit Kaur Virk | Optometrist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-29 |
| 1700499670 | Christine Palathinkal | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-08-28 |
| 1235748252 | Valerie Marie Campos | Registered Nurse | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-07-27 |
| 1124636634 | Da Som Kim | Pharmacist | 79 Middleville Rd, Northport, NY 11768-2200 | 2020-07-21 |
| 1518584341 | Irene Sofia Koutsidis | Social Worker | 79 Middleville Rd, Northport, NY 11768-2296 | 2020-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649753088 | Tania Morris | Developmental Therapist | 130 Main St, #1, Northport, Ny 11768, Northport, NY 11768 | 2018-09-12 |
| 1639698343 | Karen Yuan Wong | Student in an Organized Health Care Education/Training Program | 79 Middleviille Rd., Optometry 123, Northport, NY 11768 | 2017-09-13 |
| 1821514795 | Village Speech and Language Pllc | Clinic/Center | 62 Makamah Beach Rd, Northport, NY 11768 | 2017-08-22 |
| 1073960415 | Dennis Falco | Private Vehicle | 5 Captain Richards Ln, Fort Salonga, NY 11768 | 2016-05-16 |
| 1679938252 | Debra Marie Failla | Psychologist | 260 Main Street, Suite 202, Northport, NY 11768 | 2015-12-23 |
| 1649649096 | Lillian Patricia Fais | Specialist | 26 Josephine Lane, Fort Salonga, NY 11768 | 2015-09-16 |
| 1427349505 | Kathleen Ann Korwasky | Occupational Therapist | 18 Dick Court, Northport, NY 11768 | 2011-04-25 |
| 1043448822 | Gianna Rose Ferranti | Dentist | 19 Winkle Point Road, Northport, NY 11768 | 2009-06-30 |
| 1861658213 | Barbara Ann Hansen | Registered Nurse | 78 Eatons Neck Rd, Northport, NY 11768 | 2008-08-05 |
| 1902060148 | Dana Ruth Cohen | Psychiatry & Neurology | 79 Middleville Road, Bldg 64, Northport Vamc, Northport, NY 11768 | 2008-07-16 |
| Find all providers in zip 11768 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194912147 | Heidi Dawn Dyer-raley | Dietitian, Registered | 505 Energy Center Bloulevard, Suite 602, Northport, AL 35473 | 2007-10-03 |
| 1437243458 | Beverly Blossom Hermalyn | Dietitian, Registered | 79 Middlevile Road, Northport, NY 11768 | 2006-10-03 |
| 1578661948 | Rita Rover | Dietitian, Registered | 168 Laurel Ave, Northport, NY 11768-3168 | 2006-09-20 |
| 1609238104 | Lisa Angadi | Dietitian, Registered | 79 Middleville Rd, Northport, NY 11768-2200 | 2016-03-23 |
| 1114392321 | Georgina Hignell | Dietitian, Registered | 79 Middleville Rd, Northport, NY 11768-2200 | 2015-12-14 |
| 1851705537 | Christine Going | Dietitian, Registered | 79 Middleville Rd, Northport, NY 11768-2200 | 2014-06-20 |
| 1043639867 | Cara Amcher | Dietitian, Registered | 79 Middleville Rd, Northport, NY 11768-2200 | 2014-04-09 |
| 1528306610 | Michelle Gioe | Dietitian, Registered | 79 Middleville Rd, Northport, NY 11768-2200 | 2013-01-23 |
| 1467797100 | Marina Stauffer, Registered Dietitian, Certified Dietitian Nutritionis | Dietitian, Registered | 694 Fort Salonga Rd, Northport, NY 11768-3147 | 2012-12-06 |
| 1821366410 | Suzanne Elizabeth Sullivan | Dietitian, Registered | 79 Middleville Rd, Northport, NY 11768-2200 | 2011-12-09 |
| Find all providers in NORTHPORT | ||||
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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.