MICHELLE ANNE VAN NAME (NPI# 1811163363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811163363 |
| Entity Type | Individual |
| Full Name | MICHELLE ANNE VAN NAME |
| Practice Address |
1 Long Wharf Dr Suite 503 New Haven CT 06511-5991 |
| Practice Telephone | 2037855809 |
| Mailing Telephone | 2037855809 |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2015-06-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
50005 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
1 LONG WHARF DR SUITE 503 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-5991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174510440 | Jane Lawrence-riddell | Nurse Practitioner | 1 Long Wharf Dr, Suite 105, New Haven, CT 06511-5991 | 2005-10-03 |
| 1033726856 | Mekessia Richards-carby | Nurse Practitioner | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2020-09-25 |
| 1942843081 | Cassandra Marie Irizarry | Counselor | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2019-10-22 |
| 1003463159 | Ashley Antonucci | Nurse Practitioner | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2019-08-22 |
| 1720559438 | Yvonne Bolumole | Registered Nurse | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2018-12-07 |
| 1295206803 | Debbie A. Koonce | Licensed Practical Nurse | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2018-12-07 |
| 1659862274 | Nathan Lipkind | Social Worker | 1 Long Wharf Dr, New Haven, CT 06511 | 2018-05-21 |
| 1851893549 | Sammy Falcon | Counselor | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2018-03-08 |
| 1891217022 | Lisa Magistro | Nurse Practitioner | 1 Long Wharf Dr, New Haven, CT 06511-5991 | 2017-07-10 |
| 1972036622 | Julie A. Mcglynn | Genetic Counselor, MS | 1 Long Wharf Dr, 2nd Floor; Room 293, New Haven, CT 06511-5991 | 2017-04-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330571 | Allison Elizabeth Pratt | Occupational Therapist | 625 Whitney Ave, Apt 5, New Haeven, CT 06511 | 2020-09-11 |
| 1881213346 | Sarah Bleicher | Registered Nurse | Yale Health, 55 Lock St, New Haven, CT 06511 | 2020-04-14 |
| 1083268395 | Danielle Lee Mcpherson | Pharmacist | Yale New Haven Hospital 55 Park Street, New Haven, CT 06511 | 2019-07-25 |
| 1528533866 | Alexia Levin | Social Worker | 98/100 York St, New Haven, CT 06511 | 2018-10-12 |
| 1861970097 | Orthocare Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1450 Chapel St Ste Sg15, New Haven, CT 06511 | 2018-07-31 |
| 1609352418 | Susannah Frew | Social Worker | 2 Eld Street, Apt 6, New Haven, CT 06511 | 2018-07-15 |
| 1851881965 | Empowerment Counseling Services, LLC | Counselor | 427 Dixwell Ave, New Haven, CT 06511 | 2018-05-14 |
| 1487173951 | Karine Giasson-gariepy | Student in an Organized Health Care Education/Training Program | Yale University Department of Psychiatry, 300 George Street, Suite 901, New Haven, Ct 06511, New Haven, CT 06511 | 2017-09-15 |
| 1568980696 | Anna Reutenauer | Dentist | 123 York St Ste 4l, New Haven, CT 06511 | 2017-09-08 |
| 1083134753 | Darin Dolezal | Student in an Organized Health Care Education/Training Program | 200 South Frontage Road, Ep2 2nd Floor - 612, Dept of Pathology, New Haven, CT 06511 | 2017-06-23 |
| Find all providers in zip 06511 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174720957 | Stephan Siebel | Pediatrics | 330 Cedar St # 3103, New Haven, CT 06510-3218 | 2007-06-27 |
| 1417300203 | Apoorva Ravindranath Waikar | Pediatrics | 20 York St Dept Of, New Haven, CT 06510-3220 | 2016-07-18 |
| 1578975488 | Kelly Joseph | Pediatrics | 20 York St, New Haven, CT 06510-3220 | 2014-05-27 |
| 1376986711 | Jennifer Sarhis Avigdor | Pediatrics | 20 York St, Ynhh Dept Pediatric Endocrinology, New Haven, CT 06510-3220 | 2013-04-16 |
| 1194084541 | Stephanie Lynn Samuels | Pediatrics | 1 Park St, New Haven, CT 06504-8901 | 2012-05-04 |
| 1346521531 | Lisa Michelle Cruz-aviles | Pediatrics | 20 York St, New Haven, CT 06510-3220 | 2011-09-01 |
| 1265738389 | Cemre Robinson | Pediatrics | 15 York St, New Haven, CT 06510-3221 | 2011-02-07 |
| 1851628358 | Anisha D. Patel | Pediatrics | 1 Long Wharf Dr, 2nd Floor, New Haven, CT 06511-5991 | 2009-11-04 |
| 1851581045 | Eda Cengiz | Pediatrics | 333 Cedar St, Lmp 3103, New Haven, CT 06510-3206 | 2007-07-25 |
| 1841496676 | Karena L Swan | Pediatrics | 800 Howard Ave, Yale Physicians Bldg, New Haven, CT 06519-1369 | 2007-06-27 |
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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.