DR. DIANA IMMENHAUSEN (NPI# 1821331604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821331604 |
| Entity Type | Individual |
| Full Name | DR. DIANA IMMENHAUSEN |
| Credential | D.O. |
| Practice Address |
3330 Noyac Road Burkeshire Court Bldg A Sag Harbor NY 11963 |
| Mailing Address |
57 Hampton Rd Suite 201 Southampton NY 11968-4973 |
| Practice Telephone | 6317252112 |
| Practice Fax Number | 6317257180 |
| Mailing Telephone | 6317252112 |
| Mailing Fax Number | 6317257180 |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2020-02-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 283013 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
3330 NOYAC ROAD BURKESHIRE COURT BLDG A |
| City | SAG HARBOR |
| State | NY |
| Zip Code | 11963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549807 | Twentyseveneastphysiotherapy PC | Physical Therapist | 34 Bay Street, Suite 206, Sag Harbor, NY 11963 | 2020-02-10 |
| 1407351646 | Sagaponack Medical PC | Clinic/Center | 3350 Noyack Rd, Sag Harbor, NY 11963 | 2018-03-29 |
| 1386849651 | Kimberlee A Sherman | Registered Nurse | 1155 Bridghampton Turnpike, Bridgehampton, NY 11963 | 2007-06-18 |
| 1720280316 | Glenn Neal Goodman | Chiropractor | 3334 Noyac Road, Sag Harbor, NY 11963 | 2007-06-05 |
| 1811198203 | Jaime Lynn Kosinski | Speech-Language Pathologist | 22 Oak Drive, North Haven, Sag Harbor, NY 11963 | 2007-05-31 |
| 1942425798 | Victoria L Sharp | Internal Medicine | 11 Ninevah Pl, Sag Harbor, NY 11963 | 2007-04-16 |
| 1356462618 | Tod Reed Granger | Dentist | 3330 Noyac Road, Bldg B, Sag Harbor, NY 11963 | 2007-04-03 |
| 1841325628 | Suzanne Jayne Kirby | Chiropractor | 3334 Noyac Rd, Sag Harbor, NY 11963 | 2007-02-22 |
| 1427194745 | Sag Harbor Ufsd | Local Education Agency (LEA) | 200 Jermain Avenue, Sag Harbor, NY 11963 | 2007-01-30 |
| 1710045208 | Stephen James Petruccelli | Chiropractor | 39 Division Street, Sag Harbor, NY 11963 | 2006-12-05 |
| Find all providers in zip 11963 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346432077 | Ilona Katarzyna Polak | Family Medicine | 34 Bay St # 103, Sag Harbor, NY 11963-3104 | 2007-08-16 |
| 1487788477 | Sidney Macdonald Baker | Family Medicine | 71 Ferry Rd, Sag Harbor, NY 11963-1332 | 2007-03-14 |
| 1699058958 | Medical Office of Doctor Ilona K Polak PC | Family Medicine | 34 Bay St # 103, Sag Harbor, NY 11963-3104 | 2011-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1336749571 | Chowdhury Medical PC | Family Medicine | 155 Alkier St, Brentwood, NY 11717-5129 | 2020-10-27 |
| 1356940084 | Rebecca Jean Smouse | Family Medicine | 1107 Prendergast Ave, Jamestown, NY 14701-3315 | 2020-10-23 |
| 1336748136 | Rapha House Calls | Family Medicine | 2 Fernglade Ct, Chester, NY 10918-2637 | 2020-10-22 |
| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | SAG HARBOR |
| Zip Code | 11963 |
Please comment or provide details below to improve the information on DR. DIANA IMMENHAUSEN.
| 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.