ST JOSEPHS MEDICAL PC (NPI# 1942501747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942501747 |
| Entity Type | Organization |
| Organization Name | ST JOSEPHS MEDICAL PC |
| Practice Address |
5100 W Taft Rd (one of 9 Dba Locations for Corporation) Liverpool NY 13088-3807 |
| Mailing Address |
5112 W Taft Rd Suite L Liverpool NY 13088-4868 |
| Practice Telephone | 3154522828 |
| Practice Fax Number | 3154522870 |
| Mailing Telephone | 3154522501 |
| Mailing Fax Number | 3154522510 |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2013-09-18 |
| Authorized Official Name | DR. SANDRA M SULIK (PRESIDENT) |
| Authorized Official Telephone | 3154522501 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
5100 W TAFT RD (ONE OF 9 DBA LOCATIONS FOR CORPORATION) |
| City | LIVERPOOL |
| State | NY |
| Zip Code | 13088-3807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023015500 | Jody S Bleier | Internal Medicine | 5100 W Taft Rd, Suite 4j, Liverpool, NY 13088-3807 | 2005-06-30 |
| 1528620812 | Colleen Byrnes | Nurse Practitioner | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2019-07-08 |
| 1851866727 | Kathryn Quinn Manion | Clinic/Center | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-10-08 |
| 1225514623 | Shannon M Roach | Nurse Practitioner | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-07-18 |
| 1497263826 | Kimberly Cleary | Registered Nurse | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2018-01-19 |
| 1184077885 | Maia Czarnecki | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2016-07-18 |
| 1174974216 | Jenna Marie Laskey | Family Medicine | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2016-06-30 |
| 1669838108 | Phitsamai Thatvihane | Nurse Practitioner | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2016-01-14 |
| 1992160188 | Melissa Buttner | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2015-12-15 |
| 1538532940 | Chelsey Brooks | Physician Assistant | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2015-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878966 | Anthony Edward Blumetti | Psychologist | 5100 W. Taft Road, Suite 3b, Liverpool, NY 13088 | 2019-12-12 |
| 1609350016 | Alice Nellenbach | Physical Therapy Assistant | 346 Electronics Pkwy, Liverpool, NY 13088 | 2018-09-20 |
| 1043741457 | Dawn Marie Thomas | Licensed Practical Nurse | 212 Old Liverpool Road, Building 7 Apartment 6, Liverpool, NY 13088 | 2017-03-27 |
| 1154775633 | Arielle L Leonard | Massage Therapist | 609 7th N. Street, Suite 2, Liverpool, NY 13088 | 2016-04-20 |
| 1942664362 | Accessibility Solutions, Inc. | Contractor | 115 Luther Avenue, Liverpool, NY 13088 | 2016-04-12 |
| 1497176333 | Sergey Golovko | Psychiatry & Neurology | 125 Sun Harbor Dr, Liverpool, NY 13088 | 2013-12-19 |
| 1205275286 | Brandon William Crandall | Nurse Practitioner | 5100 West Taft Rd., Suite 1c, Liverpool, NY 13088 | 2013-06-23 |
| 1184976805 | Audrey Irene Tyszka | Social Worker | 5100 W Taft Rd Ste 1f, Liverpool, NY 13088 | 2012-10-04 |
| 1790049096 | Kelley Beth Burt | Speech-Language Pathologist | 110 Elwood Davis Road, Liverpool, NY 13088 | 2012-07-02 |
| 1811288954 | Nedim Ruhotina | Urology | 100 Metropolitan Park Drive, Suite 100, Liverpool, NY 13088 | 2011-04-24 |
| Find all providers in zip 13088 | ||||
| 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 |
|---|---|---|---|---|
| 1710546049 | Britnee Nichole Williams | Family Medicine | 1 Galbraith Ct, Liverpool, NY 13090-3904 | 2019-06-11 |
| 1023186061 | Brian Keith Smith | Family Medicine | 8324 Oswego Rd, Ste D, Liverpool, NY 13090-1086 | 2006-11-30 |
| 1164597498 | Lauri Ann Fairbanks Doane | Family Medicine | 8100 Oswego Road, Suite 220, Liverpool, NY 13090 | 2006-11-21 |
| 1528000668 | Nancy C Blake | Family Medicine | 7523 Morgan Rd, Village Medical of Cny, Liverpool, NY 13090-3538 | 2006-06-12 |
| 1124008263 | Christian L Holcomb | Family Medicine | 8134a Oswego Rd, Liverpool, NY 13090 | 2006-01-17 |
| 1174974216 | Jenna Marie Laskey | Family Medicine | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2016-06-30 |
| 1104276252 | Ny Primary Care Practice PC | Family Medicine | 7375 Oswego Rd, Suite 2, Liverpool, NY 13090-3717 | 2016-06-20 |
| 1629324843 | Sylvia Lee | Family Medicine | 5100 W Taft Rd, Liverpool, NY 13088-3807 | 2012-07-25 |
| 1174802540 | Christian L Holcomb Md, PC | Family Medicine | 8134 Oswego Rd, Suite A, Liverpool, NY 13090-1500 | 2011-08-16 |
| 1215215421 | Wei-yu Chou | Family Medicine | 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 | 2011-07-22 |
| Find all providers in LIVERPOOL | ||||
Please comment or provide details below to improve the information on ST JOSEPHS MEDICAL PC.
| 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.