CRYSTAL WELLS (NPI# 1770009326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770009326 |
| Entity Type | Individual |
| Full Name | CRYSTAL WELLS |
| Credential | NP-C |
| Practice Address |
39 Brentwood Rd Bay Shore NY 11706-8031 |
| Mailing Address |
1424 6th St West Babylon NY 11704-4522 |
| Practice Telephone | 6315917400 |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2017-08-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F308248 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902281058 | Crystal Wells | Dental Hygienist | 25473 Briar Dr, Oak Park, MI 48237-1334 | 2015-07-29 |
| 1881159549 | Crystal Wells | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2019-02-07 |
| Street Address |
39 BRENTWOOD RD |
| City | BAY SHORE |
| State | NY |
| Zip Code | 11706-8031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922654037 | Mahmoud Mohammedamin M Bokhari | Internal Medicine | 39 Brentwood Rd, Bay Shore, NY 11706-8031 | 2019-08-14 |
| 1891288031 | Tara Leigh Hertz | Registered Nurse | 39 Brentwood Rd, Bay Shore, NY 11706 | 2018-06-12 |
| 1235628926 | Janine Thomesen | Nurse Practitioner | 39 Brentwood Rd, Bay Shore, NY 11706-8031 | 2018-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598394173 | Erin Marie Barlow | Student in an Organized Health Care Education/Training Program | Southside Emergency Department 301 East Main Street, Bay Shore, NY 11706 | 2020-04-06 |
| 1003460890 | Bay Shore Brightwaters Rescue Ambulance Inc. | Ambulance | 911 Aletta Place, Bay Shore, NY 11706 | 2019-07-30 |
| 1861980872 | Raffy Gutman | Student in an Organized Health Care Education/Training Program | Southside Hospital Family Medicine, 301 E Main St, Bay Shore, NY 11706 | 2018-04-25 |
| 1609371004 | Sengal Kelit Alazar | Student in an Organized Health Care Education/Training Program | South Side Hospital Emergency Department - Northwell, 301 East Main Street, Bay Shore, NY 11706 | 2018-03-27 |
| 1780198671 | Stefany Gabriela Armijos | Social Worker | 144 Fifth Ave, Bay Shore, NY 11706 | 2017-11-30 |
| 1417476771 | Jazmin Unda Jimenez | Licensed Practical Nurse | 236 Adams Ave, Bay Shore, NY 11706 | 2017-09-18 |
| 1013436989 | People Pushers LLC | Non-emergency Medical Transport (VAN) | 50 Corbin Ave, Suite D, Bay Shore, NY 11706 | 2017-09-12 |
| 1871011585 | Life Acupuncture & Massage Therapy P.C. | Acupuncturist | 387 East Main Street Suite 104, Bayshore, NY 11706 | 2017-09-01 |
| 1558881458 | Wilda Novembre | Licensed Practical Nurse | 1742 North Thompson Drive, Bayshore, NY 11706 | 2017-06-21 |
| 1194184085 | Georgette Prawl | Nurse's Aide | 54 1st Avenue, Bayshore, NY 11706 | 2016-02-19 |
| Find all providers in zip 11706 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073175600 | John F Young | Nurse Practitioner | 301 E Main St # Pst, Bay Shore, NY 11706-8408 | 2019-07-03 |
| 1003476631 | Cheryl Schoedler | Nurse Practitioner | 1075 Cassel Ave, Bay Shore, NY 11706-6115 | 2019-06-17 |
| 1184148827 | Elizabeth Bonilla | Nurse Practitioner | 301 E Main St Bldg 217, Bay Shore, NY 11706-8408 | 2017-08-02 |
| 1265858377 | Princy Paulson | Nurse Practitioner | 26 Debora Ct, Bay Shore, NY 11706-4056 | 2014-03-13 |
| 1043599319 | Iverine M Anderson | Nurse Practitioner | 24 Princeton Street, Bay Shore, NY 11706-4237 | 2011-08-04 |
| 1780815480 | Nicole Louis Beaubrun | Nurse Practitioner | 1211 Howells Rd, Bay Shore, NY 11706-1945 | 2009-07-30 |
| 1346425352 | Cori Lynn Murphy-phillips | Nurse Practitioner | 116 S Penataquit Ave, Bay Shore, NY 11706-8825 | 2008-01-08 |
| 1457540601 | Joseph A Fasano | Nurse Practitioner | 280 Montauk Highway, Bay Shore, NY 11706-9182 | 2007-10-23 |
| 1346895521 | Andrea Alvarado | Nurse Practitioner | 301 E Main St, Bay Shore, NY 11706-8408 | 2019-08-05 |
| 1699290288 | Argelia Nurse Practitioner In Adult Health PC | Nurse Practitioner | 200 Howells Rd, Bay Shore, NY 11706-5351 | 2017-08-04 |
| Find all providers in BAY SHORE | ||||
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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.