MR. DOMINICK C. MARICONDA (NPI# 1790702462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790702462 |
| Entity Type | Individual |
| Full Name | MR. DOMINICK C. MARICONDA |
| Credential | PA-C |
| Practice Address |
20 York St Cb 2045 New Haven CT 06504-8900 |
| Mailing Address |
11 E Gate Rd Guilford CT 06437-2263 |
| Practice Telephone | 2036888993 |
| Mailing Telephone | 2034581634 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 000794 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
20 YORK ST CB 2045 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06504-8900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376547042 | Kimberly C Irwin | Specialist | 20 York St, New Haven, CT 06510-3220 | 2005-06-09 |
| 1225639644 | Lauren Marie Astorino | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-11-03 |
| 1598365215 | Apphia Rose Harris | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-10-30 |
| 1861091365 | Melissa Todice | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-10-26 |
| 1528665213 | Rebecca Dorothy Harrison | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-10-06 |
| 1467068551 | Marissa Meegan Sanca | Registered Nurse | 20 York St, New Haven, CT 06510-3220 | 2020-09-23 |
| 1093321234 | Oksana Petsukh | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-09-22 |
| 1841806114 | Madiha Shah | Pharmacist | 20 York St, New Haven, CT 06510-3220 | 2020-09-21 |
| 1053926303 | Tanyeri Barak | Student in an Organized Health Care Education/Training Program | 20 York St, Tompkins 226, New Haven, CT 06510-3220 | 2020-09-14 |
| 1548875776 | Lisa Wrubel | Registered Nurse | 20 York St, New Haven, CT 06510-3220 | 2020-09-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962872523 | Diana G Poulsen | Physician Assistant | Yale New Haven Pediatric Ed, 1 Park St, New Haven, CT 06504 | 2015-09-25 |
| 1679715395 | Rhonda Leigh Sawyer | Physician Assistant | 840 Howard Avenue, New Haven, CT 06504 | 2009-03-26 |
| 1205086915 | Christiane Brigitte Sabourin | Nurse Practitioner | 20 York Cb-2041, Ynh Medical Services PC, New Haven, CT 06504 | 2008-09-30 |
| 1821135187 | Jorge E Dotto | Pathology | Yale New Haven Hosp - Pathology, 20 York Street, Cp2-631, New Haven, CT 06504 | 2007-01-30 |
| 1528155009 | John K Hickey | Physician Assistant | 20 York St - Cb2041, Mill Hill Medical Conslutants, Inc, New Haven, CT 06504 | 2006-10-06 |
| 1750495610 | Leslie Hetzel O'connor | Clinical Nurse Specialist | Yale- New Haven Hospital, 20 York Street, New Haven, CT 06504 | 2006-08-18 |
| 1790729507 | Cynthia Anne Nielsen | Social Worker | 20 York St., Yale-new Haven Hospital, New Haven, CT 06504 | 2006-06-15 |
| 1023051901 | Michele N. Nyman Harris | Social Worker | Yale-new Haven Hospital, 20 York Street, New Haven, CT 06504 | 2006-06-14 |
| 1386627503 | Kerstin Elizabeth Calia | Internal Medicine | 20 York St Cb-2041, New Haven, CT 06504 | 2005-11-22 |
| 1598761546 | Edward Francois | Internal Medicine | 20 York Street Cb 2041, New Haven, CT 06504 | 2005-06-23 |
| Find all providers in zip 06504 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170546 | Kanwon Garley | Physician Assistant | 371 Alden Ave Apt 12b, New Haven, CT 06515-2146 | 2020-07-06 |
| 1366097271 | Lana Monashkin | Physician Assistant | 939 State St Apt C, New Haven, CT 06511-7318 | 2019-08-07 |
| 1013479898 | Andrea Ferraro | Physician Assistant | 35 Park St Rm 209, New Haven, CT 06519-1110 | 2019-04-02 |
| 1255875035 | Sarah Geanne Coffin | Physician Assistant | 51 Perkins St, New Haven, CT 06513-3210 | 2016-12-13 |
| 1790146066 | Philip Logan | Physician Assistant | 112 Dwight St Apt 29, New Haven, CT 06511-4532 | 2016-03-15 |
| 1962872523 | Diana G Poulsen | Physician Assistant | Yale New Haven Pediatric Ed, 1 Park St, New Haven, CT 06504 | 2015-09-25 |
| 1992192827 | Theodora Fraser Mcpherson | Physician Assistant | 151 Clifton St, New Haven, CT 06513-3319 | 2015-04-17 |
| 1851658561 | Tara Cotton | Physician Assistant | 20 York St Spc 2213, Mdrad Diagnostic Radiology, New Haven, CT 06510-3220 | 2012-04-19 |
| 1508147745 | Molly E Band | Physician Assistant | 1 Park St Fl 2, New Haven, CT 06504-8901 | 2011-09-01 |
| 1114243482 | Megan Elizabeth Dieterich | Physician Assistant | 175 W Park Ave, New Haven, CT 06511-2928 | 2010-04-12 |
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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.