THEODORE BLASZCZYK (NPI# 1962588640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962588640 |
| Entity Type | Individual |
| Full Name | THEODORE BLASZCZYK |
| Credential | M.D. |
| Practice Address |
200 E Main St Ste 1e Smithtown NY 11787 |
| Mailing Address |
45 Research Way Ste 208a East Setauket NY 11733-6401 |
| Practice Telephone | 6312654567 |
| Practice Fax Number | 6312654704 |
| Mailing Telephone | 6316752125 |
| Mailing Fax Number | 6316752628 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2019-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 169211 | NY | Allopathic & Osteopathic Physicians |
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
169211 | NY | Allopathic & Osteopathic Physicians |
| N | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
169211 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
200 E MAIN ST STE 1E |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477644698 | Polly Kanganis | Obstetrics & Gynecology | 200 E Main St Ste 1e, Smithtown, NY 11787-2812 | 2006-09-27 |
| 1306127030 | Jefferson Medical Surgery PC | Surgery | 200 E Main St Ste 1e, Smithtown, NY 11787-2812 | 2011-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
| Find all providers in zip 11787 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992164974 | David M. Shobin, Md,women's Health, Pllc | Obstetrics & Gynecology | 498 Route 111, Suite B, Smithtown, NY 11787-4732 | 2016-02-18 |
| 1609263318 | Lindsey Buchin | Obstetrics & Gynecology | 48 Ny-25, #207, Smithtown, NY 11787-1178 | 2015-04-20 |
| 1477644698 | Polly Kanganis | Obstetrics & Gynecology | 200 E Main St Ste 1e, Smithtown, NY 11787-2812 | 2006-09-27 |
| 1043320344 | Charles T Mann | Obstetrics & Gynecology | 48 Route 25a Ste 207, Smithtown, NY 11787-1448 | 2006-08-30 |
| 1023428455 | Jennifer Slagus | Obstetrics & Gynecology | 48 Route 25a Ste 207, Smithtown, NY 11787-1448 | 2014-05-07 |
| 1770765414 | St. Catherine's Bone Density | Obstetrics & Gynecology | 50 Route 25a, Smithtown, NY 11787-1348 | 2007-12-05 |
| 1972622520 | Lisa Nelly Amorin | Obstetrics & Gynecology | 48 Route 25a Ste 207, Smithtown, NY 11787-1448 | 2007-03-28 |
| 1730248659 | Nicholas John Kleopoulos M.d. | Obstetrics & Gynecology | 200 E Main St, Smithtown, NY 11787-2812 | 2006-12-06 |
| 1861563504 | Dinesh Lalji Vadher | Obstetrics & Gynecology | 48 Route 25a, Suite 202, Smithtown, NY 11787-2814 | 2006-11-13 |
| 1447360615 | Jerry A Wider | Obstetrics & Gynecology | 48 Route 25a, Suite 207, Smithtown, NY 11787-1431 | 2006-08-30 |
| Find all providers in SMITHTOWN | ||||
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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.