Mary Elizabeth Defabrizio, APN-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NN05453600 Issued in NJ

Practice address

25 5TH Ave
Haskell, NJ 07420-1075

Phone

(973) 839-6000

NPI assigned

Apr 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154540094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 OSCEOLA RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705060",
            "telephone_number": "973-831-7463",
            "fax_number": "973-839-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 5TH AVE",
            "city": "HASKELL",
            "state": "NJ",
            "postal_code": "074201075",
            "telephone_number": "973-839-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFABRIZIO",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "APN-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NN05453600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Haskell, NJ
• Providers in Haskell, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.