NELLI LAKIS (NPI# 1902186323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902186323 |
| Entity Type | Individual |
| Full Name | NELLI LAKIS |
| Credential | MD |
| Practice Address |
593 Eddy Street Apc 12 Providence RI 02903 |
| Practice Telephone | 4014444000 |
| Mailing Telephone | 4014444000 |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2016-03-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZN0500X |
Pathology Specialization: Neuropathology |
207ZN0500X | RI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | STATE LICENSE | LP03419 | 01 |
| Street Address |
593 EDDY STREET, APC 12 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962473314 | Lionel G Bercovitch | Dermatology | 593 Eddy Street, Apc-10, Providence, RI 02903 | 2006-02-01 |
| 1205942521 | Shoshana Landow | Dermatology | 593 Eddy Street, Apc-10, Providence, RI 02903 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475755 | Sarah Fellows | Student in an Organized Health Care Education/Training Program | 350 Eddy Street, Uri Nursing Education Center, Providence, RI 02903 | 2020-10-20 |
| 1093328262 | Esther Robbins | Social Worker | 290 West Exchange St., Suite 100, Providence, RI 02903 | 2020-08-27 |
| 1720619489 | Ivy Marie Mcdonald | Behavioral Analyst | 290 W Exchange St #101, Providence, RI 02903 | 2020-01-31 |
| 1447802707 | Natalie Monaghan, LLC | Social Worker | 545 South Water Street, Providence, RI 02903 | 2019-07-16 |
| 1760049522 | Daniel Steven Alanko | Pediatrics | 293 Eddy Street, Providence, RI 02903 | 2019-05-28 |
| 1154894368 | Margaret Emily Dyson | Behavior Technician | 290 W. Exchange St, Providence, RI 02903 | 2019-01-10 |
| 1497235014 | Yao Zhou Liu | Surgery | 593 Eddy St - Rhode Island Hospital, Providence, RI 02903 | 2018-08-14 |
| 1558840645 | Tamara Gore | Behavior Technician | 290 W Exchange Street Suite 101, Providence, RI 02903 | 2018-08-09 |
| 1437642709 | Adrian Cotarelo | Student in an Organized Health Care Education/Training Program | 174 Wickenden St, Apt. 3rd Floor, Providence, RI 02903 | 2018-06-12 |
| 1356833024 | Natalie Rita Noonan | Clinical Neuropsychologist | 593 Eddy St Ste 430, Providence, RI 02903 | 2018-05-30 |
| Find all providers in zip 02903 | ||||
| Taxonomy Code | 207ZN0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Neuropathology |
| A neuropathologist is expert in the diagnosis of diseases of the nervous system and skeletal muscles and functions as a consultant primarily to neurologists and neurosurgeons. The neuropathologist is knowledgeable in the infirmities of humans as they affect the nervous and neuromuscular systems, be they degenerative, infectious, metabolic, immunologic, neoplastic, vascular or physical in nature. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pathology. The Certification is NO longer provided. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194100081 | Teddi Lynn Tubre | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2015-07-21 |
| 1194018259 | Mohammad Mahboob | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2011-05-24 |
| 1710277447 | Darren Matthew Groh | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2011-04-14 |
| 1942439245 | Dorota Latuszynski | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2009-07-08 |
| 1033315205 | Mirfrida Geller | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2007-06-25 |
| 1194927590 | Victor E. Alvarez | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2007-06-05 |
| 1609813914 | John E Donahue | Pathology | 593 Eddy St, Department of Pathology Apc 12, Providence, RI 02903-4923 | 2006-06-02 |
| 1558308270 | Douglas C Anthony | Pathology | 593 Eddy St, Apc Building, 12-106, Providence, RI 02903-4923 | 2006-06-01 |
| 1962449157 | Suzanne Delamonte | Pathology | 593 Eddy St, Department of Patho;ogy Apc - 12, Providence, RI 02903-4923 | 2006-05-31 |
| 1811944127 | Edward Stopa | Pathology | 593 Eddy St, Department of Pathology Apc-12, Providence, RI 02903-4923 | 2006-05-30 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02903 |
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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.