Emma Gorynski Daboll, M.D.
Individual provider Active NPI Pediatrics Physician · Bethpage, NY
NPI 1083025191 · NPPES record last updated Feb 26, 2021
Key facts
- NPI
- 1083025191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 288123 (NY)
- Practice address
- 1055 Stewart Avenue
Bethpage, NY 11714-3596 - Phone
- (516) 938-0100
- Fax
- (516) 938-0120
- NPI assigned
- May 12, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 288123 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Flatiron Pediatrics of Port PC | Pediatrics | Past |
Accepting new patients |
| Flatiron Pediatrics, PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- emma.daboll.1@13092.direct.athenahealth.com
- https://api.platform.athenahealth.com/13092/brand/1/csg/1/fhir/r4
- emma.gorynski.1@13092.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 288123 | NY | Yes |
Addresses
Primary practice location
1055 Stewart Avenue
Bethpage, NY 11714-3596
Mailing address
Advantagecare Physicians, PC
55 Water Street 2ND Floor Cred Dept
New York, NY 10041
Phone (646) 680-2888
Other practice location 1
27 E 22nd St
New York, NY 10010-5300
Phone (212) 460-5600
Other providers in Bethpage, NY
- CVS Albany LLC
- Marie P Czarniecki
- Salina M D'Abreu
- Yevgeniya D'Alessandro
- Joseph M D'Ambrosio
- Joyce H Damino
- Abiola Desola Danmola
- Paul Dantes
- Daryl Perlman Physician PC
- David a. Gentile, DO Cacpc
All providers in Bethpage, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.