Individual provider Active NPI

Teresa Mikolanda, MS SPECIAL ED

  • Specialist
  • Smithtown, NY
National Provider Identifier
1093077745
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
XXX-XX-9612 Issued in NY
Practice address
8 Grassy Pond Drive
Smithtown, NY 11787
Phone
(631) 864-3691
NPI assigned
Jun 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X XXX-XX-9612 NY Primary

Addresses

Primary practice location

8 Grassy Pond Drive
Smithtown, NY 11787

Mailing address

8 Grassy Pond Drive
Smithtown, NY 11787
Phone (631) 864-3691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
XXX-XX-9612NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1093077745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GRASSY POND DRIVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-864-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 GRASSY POND DRIVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-864-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLANDA",
        "first_name": "TERESA",
        "credential": "MS SPECIAL ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "XXX-XX-9612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.