Active NPI
Marielle Zuccolo, RDN
- Registered Dietitian
- Vestal, NY
National Provider Identifier
1154876605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 006951-1
- Practice address
- 213 Tracy Creek Rd
Vestal, NY 13850-1062 - Phone
- (607) 786-9063
- NPI assigned
- Aug 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 006951-1 | NY | Primary |
Addresses
Primary practice location
213 Tracy Creek Rd
Vestal, NY 13850-1062
Mailing address
249 Glenwood Rd
Binghamton, NY 13905-1603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006951-1 | NY | MD | Registered Dietitian |
| 006951 | NY | MD | Physician Assistant |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmental Disabilities Clinic/Center
- Staten Island, NY
- NPI 1750469912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471996800000",
"number": "1154876605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "249 GLENWOOD RD",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139051603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 TRACY CREEK RD",
"city": "VESTAL",
"state": "NY",
"postal_code": "138501062",
"telephone_number": "607-786-9063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUCCOLO",
"first_name": "MARIELLE",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-24",
"last_updated": "2016-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "006951-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.