Individual provider Active NPI

Angela M Mazzeo, MSED

  • Specialist
  • North Bellmore, NY
National Provider Identifier
1003178161
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
851521 Issued in NY
Practice address
1967 Hancock Ave
North Bellmore, NY 11710-1514
Phone
(917) 576-6884
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 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 851521 NY Primary

Addresses

Primary practice location

1967 Hancock Ave
North Bellmore, NY 11710-1514

Mailing address

1967 Hancock Ave
North Bellmore, NY 11710-1514
Phone (917) 576-6884

Other identifiers 1

IdentifierTypeStateIssuer
851521OtherNYCERTIFICATIONS

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

State licenses

LicenseStateTypeSpecialty
851521NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1003178161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1967 HANCOCK AVE",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117101514",
            "telephone_number": "917-576-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1967 HANCOCK AVE",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117101514",
            "telephone_number": "917-576-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZEO",
        "first_name": "ANGELA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MSED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "851521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATIONS",
            "identifier": "851521",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bellmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.