Tara Deitrick, | |
259 1st St, Mineola, NY 11501-3957 | |
(516) 741-0570 | |
(516) 741-8276 |
Full Name | Tara Deitrick |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 44 Years |
Location | 259 1st St, Mineola, New York |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497855704 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 9330 (New York) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Endoscopy Center Of Long Island Llc | 2668370123 | 19 |
Entity Name | Endoscopy Center Of Long Island Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770718009 PECOS PAC ID: 2668370123 Enrollment ID: O20090416000311 |
Entity Name | North Shore - Lij Anesthesiology, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417401266 PECOS PAC ID: 1153602453 Enrollment ID: O20161228001498 |
Mailing Address | Practice Location Address |
---|---|
Tara Deitrick, 17 Kenwood Rd, Garden City, NY 11530-3034 Ph: (516) 248-1420 | Tara Deitrick, 259 1st St, Mineola, NY 11501-3957 Ph: (516) 741-0570 |
Virginia O'connor, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 259 1st St, Mineola, NY 11501 Phone: 516-663-0333 | |
James Jacob, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 259 1st St, Mineola, NY 11501 Phone: 516-663-0333 | |
Terrence Mcdonough, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 259 1st St, Mineola, NY 11501 Phone: 516-663-0333 | |
Edward Mcdonnell, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 259 1st St, Mineola, NY 11501 Phone: 516-663-0333 | |
Elizabeth Lawton, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 110 Willis Ave, Mineola, NY 11501 Phone: 516-294-0030 | |
Lisa Lynch, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 110 Willis Ave, Mineola, NY 11501 Phone: 516-294-0030 | |
Susan Fackelman, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 259 1st St, Mineola, NY 11501 Phone: 516-663-0333 |