June Lazaro Mariscotes

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

004226 Issued in NY

Practice address

24 Robinwood Dr
Mastic Beach, NY 11951-3206

Phone

(615) 638-5226

NPI assigned

Jun 24, 2013

Last updated

Jun 24, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Venicio Lazaro Mariscotes Jr. Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1053750943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ROBINWOOD DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119513206",
            "telephone_number": "615-638-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ROBINWOOD DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119513206",
            "telephone_number": "615-638-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARISCOTES",
        "first_name": "JUNE",
        "middle_name": "LAZARO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "004226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VENICIO",
            "last_name": "MARISCOTES",
            "middle_name": "LAZARO",
            "prefix": "MR.",
            "suffix": "JR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nedra Love
• LPN
• Jennifer Maddalena
• Maryann Manakides
• Desiree Manzitto
• Andreza Martinta, RN
• Patricia Mary Marx, LPN
• Jennifer Mas
• Mastic Beach Ambulance Company Inc
• Liana Crystal Matzen, LPN

• Physical Therapy Assistant in Mastic Beach, NY
• Providers in Mastic Beach, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.