FABIO DEOLIVEIRA (NPI# 1891214391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891214391 |
| Entity Type | Individual |
| Full Name | FABIO DEOLIVEIRA |
| Credential | PA-C |
| Practice Address |
259 1st St Mineola NY 11501-3957 |
| Mailing Address |
155 Jackson Ave Mineola NY 11501-2423 |
| Practice Telephone | 5166630333 |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2017-09-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
021304 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
259 1ST ST |
| City | MINEOLA |
| State | NY |
| Zip Code | 11501-3957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801892641 | Frederick James | Nurse Anesthetist, Certified Registered | 259 1st St, Mineola, NY 11501-3957 | 2005-06-27 |
| 1164039855 | James Jacob | Nurse Anesthetist, Certified Registered | 259 1st St, Mineola, NY 11501-3957 | 2020-09-26 |
| 1649887530 | Michael D'alto | Emergency Medicine | 259 1st St, Mineola, NY 11501-3957 | 2020-09-25 |
| 1174136121 | Anatoliy Mirkin | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-08-28 |
| 1497368823 | Sajumon K Joseph | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-08-25 |
| 1730707134 | Nathan Augustus Starkman | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-07-12 |
| 1164040143 | Melissa Dale Kersch | Nurse Practitioner | 259 1st St, Mineola, NY 11501-3957 | 2020-07-07 |
| 1518582964 | Jennifer Behbodikhah | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-06-11 |
| 1912521386 | Samuel Baskharoun | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-06-02 |
| 1346863404 | James Anthony Priftakis | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, NY 11501-3957 | 2020-05-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500350 | Steve Abraham Simon | Student in an Organized Health Care Education/Training Program | 222 Station Plaza, Suite 509, Mineola, NY 11501 | 2020-05-18 |
| 1407478167 | Frederick Milton Bosoy | Student in an Organized Health Care Education/Training Program | 259 1st St, Mineola, Ny 11501, Mineola, NY 11501 | 2020-05-15 |
| 1982226130 | Katelyn Anne Fowler | Counselor | [email protected], 410 East Jericho Tpke, Mineola, NY 11501 | 2020-05-11 |
| 1225667819 | New York Dialysis Services, Inc | Clinic/Center | 1 East Jericho Turnpike, Mineola, NY 11501 | 2020-04-06 |
| 1518500032 | Irina Victoria Kushnareva | Social Worker | 126 Saville Rd, Mineola, NY 11501 | 2019-10-28 |
| 1861046336 | Milagros M Matias | Case Manager/Care Coordinator | 39 E. Jericho Turnpike, Mineola, NY 11501 | 2019-08-01 |
| 1154974244 | Bahram Dabiri | Student in an Organized Health Care Education/Training Program | 222 Station Plaza N., Suite 620 Mineola, Mineola, NY 11501 | 2019-07-18 |
| 1972168748 | Nabeel A. Arain | Physician Assistant | 251 1st St., Mineola, NY 11501 | 2019-05-07 |
| 1598328940 | Ramsha Jabbar | Student in an Organized Health Care Education/Training Program | 222 Station Plaza North, Suite 305, Mineola, NY 11501 | 2019-04-20 |
| 1235628850 | Valentyna Erstenyuk | Student in an Organized Health Care Education/Training Program | 222 Station Plaza N, Suite 611, Mineola, NY 11501 | 2018-05-09 |
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| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417384173 | Christopher Thomas Donohue | Physician Assistant | 134 Mineola Blvd Fl 2, Mineola, NY 11501 | 2013-09-26 |
| 1184899551 | Darren M Mack | Physician Assistant | 125 Lincoln Ave Apt B4l, Mineola, NY 11501-2837 | 2008-04-28 |
| 1972785129 | Glenn Glantz | Physician Assistant | 259 1st St # Gp4, Winthrop University Hospital - Tcv, Mineola, NY 11501-3957 | 2007-11-29 |
| 1487875001 | Lauren Miele | Physician Assistant | 259 First Street, Winthrop University Hospital Gp4, Mineola, NY 11501 | 2007-05-01 |
| 1538645072 | Katie Fargnoli | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2018-07-18 |
| 1265951032 | Yesenia Gonzalez | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2017-09-13 |
| 1427411271 | Brittany Yanora | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2016-03-30 |
| 1245656222 | Michael Maglione | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2014-03-13 |
| 1245666247 | Branden Roger Vuolo | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2013-09-23 |
| 1588908016 | Nycole Abela | Physician Assistant | 259 1st St, Mineola, NY 11501-3957 | 2012-11-21 |
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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.