TRI STATE SURGICAL ASSOCIATES PLLC (NPI# 1801993175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801993175 |
| Entity Type | Organization |
| Organization Name | TRI STATE SURGICAL ASSOCIATES PLLC |
| Practice Address |
384 Crystal Run Rd Suite 201 Middletown NY 10941-4013 |
| Practice Telephone | 8456928780 |
| Practice Fax Number | 8456923439 |
| Mailing Telephone | 8456928780 |
| Mailing Fax Number | 8456923439 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2012-01-31 |
| Authorized Official Name | DR. PETER H KWON (CORPORATION PRESIDENT) |
| Authorized Official Telephone | 8456928780 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 216778 | NY | Other Service Providers |
| Street Address |
384 CRYSTAL RUN RD SUITE 201 |
| City | MIDDLETOWN |
| State | NY |
| Zip Code | 10941-4013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760456396 | Wayne Mark Weiss | Surgery | 384 Crystal Run Rd, Suite 201, Middletown, NY 10941-4013 | 2006-02-13 |
| 1316268899 | Jeanne Karson | Nurse Practitioner | 384 Crystal Run Rd, Suite 201, Middletown, NY 10941-4013 | 2010-06-18 |
| 1447573332 | Jeffrey A Braisted | Radiologic Technologist | 384 Crystal Run Rd, Suite 201, Middletown, NY 10941-4013 | 2010-03-05 |
| 1356459929 | Peter H Kwon | Specialist | 384 Crystal Run Rd, Suite 201, Middletown, NY 10941-4013 | 2006-08-25 |
| 1598700536 | Kristin L. Allison | Psychiatry & Neurology | 384 Crystal Run Rd, Suite 201, Middletown, NY 10941-4013 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407471428 | Jackeline Montoya | Case Manager/Care Coordinator | 13 Kensington Manor, Middletown, NY 10941 | 2020-06-15 |
| 1124502398 | Kimberly Dominique Mccormick | Licensed Practical Nurse | 29, Macintosh Drive, Middletown, NY 10941 | 2018-09-24 |
| 1750891081 | Heather Skinner | Case Manager/Care Coordinator | 75 Crystal Run Rd Suite 201, Middletown, NY 10941 | 2017-09-29 |
| 1295281012 | Christa Lloyd | Counselor | 15 Fortune Rd, West Middletown, NY 10941 | 2016-08-31 |
| 1023471109 | Lauren Battaglia | Occupational Therapy Assistant | 192 Tower Drive Suite 400, Middletown, NY 10941 | 2016-04-05 |
| 1992188718 | Brynn Sierra | Occupational Therapist | 21 Riverside Drive, Middletown, NY 10941 | 2015-06-30 |
| 1356788574 | Keren Denis Joseph | Custodial Care Facility | 16 Disco Dr, Middletown, NY 10941 | 2013-05-29 |
| 1902169204 | Susan A. Reilly | Specialist | 2277 Gosen Turnpike, Middletown, NY 10941 | 2012-06-21 |
| 1518229392 | Dena Sapp | Case Manager/Care Coordinator | 75 Crystal Run Rd. Suite 201, Middletown, NY 10941 | 2012-06-08 |
| 1770800542 | Orange County Medical Transportation Inc. | Taxi | 80 Wisner Avenue, Middletown, NY 10941 | 2010-05-03 |
| Find all providers in zip 10941 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164036208 | Pierremarie Chloe Vital | Specialist | 33 California Dr, Middletown, NY 10940-7543 | 2020-09-05 |
| 1215568332 | Ei Dawns Way | Specialist | 41 Mayer Dr Ph, Middletown, NY 10940-3349 | 2020-01-28 |
| 1437629722 | Beatrice Ayanna Hutcherson | Specialist | 4 Mckenzie Ct, Middletown, NY 10940-5069 | 2018-11-28 |
| 1700316486 | Jessica Maria Soto | Specialist | 192 Tower Drive, Suite 400, Middletown, NY 10940 | 2017-06-15 |
| 1669910279 | Dawn A Anderson | Specialist | 41 Mayer Dr, Ph, Middletown, NY 10940-3349 | 2017-02-02 |
| 1316481732 | Pieper Memorial Veterinary Center | Specialist | 730 Randolph Rd, Middletown, CT 06457-5331 | 2016-12-05 |
| 1477909265 | Lisa Robb | Specialist | 27 James P Kelly Way Apt 22, Middletown, NY 10940-9452 | 2016-05-11 |
| 1104221589 | Marissa Fajardo | Specialist | 7 Rodman St, Middletown, NY 10940-3205 | 2014-10-28 |
| 1962816645 | Cathleen Mackey | Specialist | 101 Rolling Meadows Road, Middletown, NY 10940-7062 | 2014-06-20 |
| 1538500723 | Lucy Ortega | Specialist | 18 Silo Ln, Middletown, NY 10940-2603 | 2013-07-16 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 10941 |
Please comment or provide details below to improve the information on TRI STATE SURGICAL ASSOCIATES PLLC.
| 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.