Debra Mastrangelo, LPN

Key facts

NPI

1194873638

Entity type

Individual (NPI type 1)

Primary specialty

Licensed Practical Nurse 164W00000X

License

220022-1 (NY)

Practice address

6432 E Port Bay Rd
Wolcott, NY 14590-9437

Phone

(315) 359-6878

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194873638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6432 E PORT BAY RD",
            "address_2": "PO BOX 222",
            "city": "WOLCOTT",
            "state": "NY",
            "postal_code": "145909437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6432 E PORT BAY RD",
            "city": "WOLCOTT",
            "state": "NY",
            "postal_code": "145909437",
            "telephone_number": "315-359-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRANGELO",
        "first_name": "DEBRA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "220022-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolcott, NY

• Casen Lange, RN
• Joella Lange
• Susan T. Lapp, BS
• Chantel Melanie Upson Lockwood, LCSW
• Charlotte L Lofgren, M.D.
• John Myers, PHARMD
• Thambirajah Nagendra, M.D.
• North Rose-Wolcott CSD
• Onondaga Physical Therapy
• Megan Christine Paliotti, M.S., CCC-SLP

All providers in Wolcott, NY · Licensed Practical Nurse in New York