MARY ELLEN BROADSTONE GAEKE, MD, LLC (NPI# 1952362485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952362485 |
| Entity Type | Organization |
| Organization Name | MARY ELLEN BROADSTONE GAEKE, MD, LLC |
| Practice Address |
82 N Breiel Blvd Middletown OH 45042-3804 |
| Practice Telephone | 5134223119 |
| Practice Fax Number | 5134201848 |
| Mailing Telephone | 5134223119 |
| Mailing Fax Number | 5134201848 |
| Enumeration Date | 2006-04-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY ELLEN GAEKE (OWNER) |
| Authorized Official Telephone | 5134223119 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
82 N BREIEL BLVD |
| City | MIDDLETOWN |
| State | OH |
| Zip Code | 45042-3804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134180664 | Mary Ellen Gaeke | Internal Medicine | 82 N Breiel Blvd, Middletown, OH 45042-3804 | 2006-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413919 | Stacey Ward | Nurse Practitioner | 1055 Summit Dr., Middletown, OH 45042 | 2020-07-06 |
| 1962978759 | Stephani Chandra Miller | Counselor | 160 N. Breiel Blvd, Middletown, OH 45042 | 2018-10-18 |
| 1124504378 | Butler County Community Health Consortium, Inc. | Clinic/Center | 601 N Breiel Blvd Ste B, Middletown, OH 45042 | 2018-07-11 |
| 1417474883 | Tiffany Marie Ott | Registered Nurse | 1229 Ellen Dr, Middletown, OH 45042 | 2017-08-27 |
| 1184074650 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 1909 Jackson Lane, Middletown, OH 45042 | 2016-06-15 |
| 1639529100 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4623 Central Avenue, Middletown, OH 45042 | 2016-06-15 |
| 1811347388 | Camelot Raalty, LLC | Intermediate Care Facility, Mentally Retarded | 4923 Hendrickson Rd, Middletown, OH 45042 | 2016-06-15 |
| 1790135234 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4895 Hendrickson Rd., Middletown, OH 45042 | 2016-06-15 |
| 1720438294 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4907 Hendrickson Rd., Middletown, OH 45042 | 2016-06-15 |
| 1174948129 | Sherry L. Flannery | Nurse Practitioner | 4961 Middletown Oxford Road, Middletown, OH 45042 | 2014-02-27 |
| Find all providers in zip 45042 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740397462 | Mid Hudson Hematology Oncology PC | Internal Medicine | 185 Rykowski Ln, Middletown, NY 10941-4019 | 2006-08-25 |
| 1134180664 | Mary Ellen Gaeke | Internal Medicine | 82 N Breiel Blvd, Middletown, OH 45042-3804 | 2006-04-02 |
| 1750381943 | Konan Chiang | Internal Medicine | 225 Dolson Ave, Suite 301, Middletown, NY 10940-6569 | 2005-07-28 |
| 1295126670 | Varun Modi | Internal Medicine | 707 E Main St, Middletown, NY 10940-2650 | 2015-02-06 |
| 1447684808 | John Savooji | Internal Medicine | 707 E Main St, Middletown, NY 10940-2650 | 2013-08-21 |
| 1811256464 | Angela Marcelino | Internal Medicine | 111 Maltese Dr, Middletown, NY 10940 | 2012-05-16 |
| 1750671228 | Ronen Justin Harel | Internal Medicine | 185 Rykowski Ln, Middletown, NY 10941-4055 | 2011-04-18 |
| 1184930430 | Abhishek V Marballi | Internal Medicine | 155 Crystal Run Rd, Middletown, NY 10941-4028 | 2010-08-25 |
| 1770811077 | Hudson Valley Hematology-oncology,pllc | Internal Medicine | 185 Rykowski Ln, Middletown, NY 10941-4019 | 2009-11-24 |
| 1730316068 | Karthikeyan Kandavelou | Internal Medicine | 536 Saybrook Rd, Middletown, CT 06457-4783 | 2009-06-12 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 45042 |
Please comment or provide details below to improve the information on MARY ELLEN BROADSTONE GAEKE, MD, LLC.
| 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.