Individual provider Active NPI

Mary Susan Barbara Zellner

  • Ambulatory Care Registered Nurse
  • New City, NY
National Provider Identifier
1174279590
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
410688 Issued in NY
Practice address
345 N Main St
New City, NY 10956-4305
Phone
(845) 831-2000
NPI assigned
Feb 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 410688 NY Primary

Addresses

Primary practice location

345 N Main St
New City, NY 10956-4305

Mailing address

164 Gibson Hill Rd
Chester, NY 10918-2314
Phone (914) 588-0284

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

State licenses

LicenseStateTypeSpecialty
410688NYMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1174279590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 GIBSON HILL RD",
            "city": "CHESTER",
            "state": "NY",
            "postal_code": "109182314",
            "telephone_number": "914-588-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564305",
            "telephone_number": "845-831-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLNER",
        "first_name": "MARY",
        "middle_name": "SUSAN BARBARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "410688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.