Individual provider Active NPI

Danielle Fazzolare, M.A. SPED

  • Specialist
  • Plainview, NY
National Provider Identifier
1295071686
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
596214121 Issued in NY
Practice address
125 E Bethpage Rd Ste 5
Plainview, NY 11803-4228
Phone
(516) 731-5588
NPI assigned
Dec 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 596214121 NY Primary
Specialist 174400000X 596213121 NY

Addresses

Primary practice location

125 E Bethpage Rd Ste 5
Plainview, NY 11803-4228

Mailing address

125 E Bethpage Rd Ste 5
Plainview, NY 11803-4228
Phone (516) 731-5588

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
596213121NYMDSpecialist
596214121NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1295071686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BETHPAGE RD STE 5",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034228",
            "telephone_number": "516-731-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BETHPAGE RD STE 5",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034228",
            "telephone_number": "516-731-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZZOLARE",
        "first_name": "DANIELLE",
        "credential": "M.A. SPED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-13",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "596214121",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "596213121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.