Individual provider Active NPI

Marcia Avezzano, RN

  • Registered Nurse
  • Poughkeepsie, NY
National Provider Identifier
1104294131
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
618736-1 Issued in NY
Practice address
601 Dutchess Tpke
Poughkeepsie, NY 12603-1922
Phone
(844) 486-4960
Fax
(845) 483-3991
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 618736-1 NY Primary

Addresses

Primary practice location

601 Dutchess Tpke
Poughkeepsie, NY 12603-1922

Mailing address

601 Dutchess Tpke
Poughkeepsie, NY 12603-1922
Phone (844) 486-4960

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
618736-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1104294131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 DUTCHESS TPKE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126031922",
            "telephone_number": "844-486-4960",
            "fax_number": "845-483-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 DUTCHESS TPKE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126031922",
            "telephone_number": "844-486-4960",
            "fax_number": "845-483-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVEZZANO",
        "first_name": "MARCIA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "618736-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.