Mary Siragusa, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

22317601 Issued in NY

Practice address

4108 Victory Blvd
Staten Island, NY 10314-6743

Phone

(718) 698-1530

Fax

(718) 982-9798

NPI assigned

Mar 13, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1063787869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146743",
            "telephone_number": "718-698-1530",
            "fax_number": "718-982-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146743",
            "telephone_number": "718-698-1530",
            "fax_number": "718-982-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAGUSA",
        "first_name": "MARY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "22317601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sioc@Bay St Optical Pavilion
• Sipa, PLLC
• Jennifer Ann Siracusa, MS., ED.
• Lisa Siracusa, RPA
• Mariano Siragusa
• Tara Siragusa, OTR/L
• Shalini Sirisena, PHYSICIAN ASSISTANT
• Sisters of Charity Health Care Systems NH Inc
• Sisters of Charity Health Care Systems NH Inc
• Mary Ann Sisto Clark, LCSW

• School Registered Nurse in Staten Island, NY
• Providers in Staten Island, NY by specialty
• School Registered Nurse in New York

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