Camilla Teresa Martini Mazetto, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P107855 Issued in NY

Practice address

30 W 63Rd St Apt 28K
New York, NY 10023-7124

Phone

(347) 997-2822

NPI assigned

Dec 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1215648142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W 63RD ST APT 28K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W 63RD ST APT 28K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237124",
            "telephone_number": "347-997-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINI MAZETTO",
        "first_name": "CAMILLA TERESA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "P107855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmazetto@williamsburgtherapygroup.com",
            "affiliation": "N",
            "address_1": "30 W 63rd St Apt 28K",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100237124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychologist in New York, NY
• Providers in New York, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.