DR. GERARDO TOLENTINO (NPI# 1861434946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861434946 |
| Entity Type | Individual |
| Full Name | DR. GERARDO TOLENTINO |
| Credential | M.D. |
| Practice Address |
5 Medical Dr Port Jefferson Station NY 11776-1595 |
| Mailing Address |
Po Box 1559 Stony Brook NY 11790-0989 |
| Practice Telephone | 6316323785 |
| Mailing Telephone | 6316323785 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0005X |
Psychiatry & Neurology Specialization: Neurodevelopmental Disabilities |
206084 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01805774 | 05 | |
| NY | AETNA | 5080569 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053849976 | Gerardo Elias Tolentino | Family Medicine | 112 Quarry Rd Ste 120, Trumbull, CT 06611-4877 | 2017-05-24 |
| Street Address |
5 MEDICAL DR |
| City | PORT JEFFERSON STATION |
| State | NY |
| Zip Code | 11776-1595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427536895 | Casey Lynn Ward | Physician Assistant | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2018-07-29 |
| 1659867711 | Adam Dalzell | Physician Assistant | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2018-07-02 |
| 1639677271 | Robert Vincent Honor | Physician Assistant | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2018-01-29 |
| 1740796465 | Mark Peter Ortiz | Psychiatry & Neurology | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2017-12-18 |
| 1417329723 | Sabrina Livoti | Physician Assistant | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2015-10-26 |
| 1487046058 | New Wave Neurology PC | Psychiatry & Neurology | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2015-02-19 |
| 1316335540 | North Suffolk Neurology, PC | Clinic/Center | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2014-12-22 |
| 1164617544 | Warren Daniel Spinner | Psychiatry & Neurology | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2007-09-10 |
| 1699852079 | Peter Wigg | Psychologist | 5 Medical Dr, Port Jefferson Station, NY 11776-1601 | 2006-11-01 |
| 1578506051 | Elisa Han | Psychologist | 5 Medical Dr, Port Jefferson Station, NY 11776-1595 | 2006-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205304219 | Melissa E Germano | Acupuncturist | 5225 Nesconset Highway Rte 347, Davis Professional Park Building 1 Suite 1, Port Jefferson Station, NY 11776 | 2018-11-07 |
| 1366962185 | Michael Louis Scicchitano Sr. | Physical Therapist | 3 Colgate Street, Port Jefferson Station, NY 11776 | 2017-06-22 |
| 1063969517 | Dana Adamkiewicz | Acupuncturist | 432 North Bicycle Path, Port Jefferson Station, NY 11776 | 2016-09-01 |
| 1538531819 | Jacqueline Rambo | Specialist | 5225 Nesconset Highway Suite 30, Port Jefferson Station, NY 11776 | 2015-10-26 |
| 1821474297 | Michael Leuci | Social Worker | 3 Premier Court, Port Jefferson Station, NY 11776 | 2015-08-07 |
| 1578978078 | Carol A. Palmer I | Acupuncturist | 34 Champlain St, Port Jefferson Station, NY 11776 | 2014-06-24 |
| 1659783371 | Janette M Sperandeo | Nurse Practitioner | 5 Roosevelt Avenue, Port Jefferson Station, NY 11776 | 2014-05-29 |
| 1578973079 | James Buchrieser | Specialist | 525 Nesconset Highway Suite 30, Port Jefferson Station, NY 11776 | 2014-05-06 |
| 1871923227 | Duran Thomas Murphy | Licensed Practical Nurse | 8 Carolyn Road, Port Jefferson Station, NY 11776 | 2013-11-22 |
| 1699104562 | Julio Genao | Massage Therapist | 213 Jayne Blvd, Portjefferson Station, NY 11776 | 2013-11-01 |
| Find all providers in zip 11776 | ||||
| Taxonomy Code | 2084P0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician or neurologist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system such as cerebral palsy, mental retardation and chronic behavioral syndromes, or neurologic conditions. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Psychiatry and Neurology, 2007. http://www.abpn.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Psychiatry and Neurology. A subspecialty certificate for NDN was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Ongoing early discussions regarding proposal. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659313617 | John C Pomeroy | Psychiatry & Neurology | 5 Medical Dr, Port Jefferson Station, NY 11776-1595 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376630442 | P. Anne Mcbride | Psychiatry & Neurology | 525 E 68th St # 140, New York, NY 10065-4870 | 2006-10-09 |
| 1376584102 | Joseph Gartner | Psychiatry & Neurology | 37 Research Way, East Setauket, NY 11733-3465 | 2006-06-10 |
| 1508077512 | Laura Whitman | Psychiatry & Neurology | 310 W 72nd St, 3a, New York, NY 10023-2675 | 2007-05-24 |
| 1295757177 | Suanne Garber Mallenbaum | Psychiatry & Neurology | 1 West Ave, Suite 215, Larchmont, NY 10538-2470 | 2006-07-23 |
| City | PORT JEFFERSON STATION |
| Zip Code | 11776 |
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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.