Mary Jensis-Carlson D P M

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

N005090 Issued in NY

Legal business name

MARY JENSIS-CARLSON D P M

Practice address

637 Willis Ave
Suite D
Williston Park, NY 11596-1154

Phone

(516) 248-8188

Fax

(516) 279-4610

NPI assigned

Dec 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mary L Jensis-Carlson, DPM

Title

Owner

Phone

(516) 248-8188

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1508002783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WILLIS AVE",
            "address_2": "STE D.",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115961154",
            "telephone_number": "516-248-8188",
            "fax_number": "516-279-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WILLIS AVE",
            "address_2": "SUITE D",
            "city": "WILLISTON PARK",
            "state": "NY",
            "postal_code": "115961154",
            "telephone_number": "516-248-8188",
            "fax_number": "516-279-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY JENSIS-CARLSON D P M",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "JENSIS-CARLSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-248-8188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N005090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marques Lopes, M.S.
• John Porter Lyons
• Teresa Lyons, MA, CCC-SLP
• Joan Madison, M.A.
• Patrick Martinucci
• Priya Mathew Chirayil, MS ADULT NP
• Sherin Cheriyan Mathew, DPT
• Maureen Camizzi Kirschner PT PC
• Jaclyn Nicole McAndrew
• Lisa Ann McArdle, MS ED

• Foot Surgery Podiatrist in Williston Park, NY
• Providers in Williston Park, NY by specialty
• Foot Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.