Individual provider Active NPI

Shassagne Prezeau

  • Registered Nurse
  • West Haverstraw, NY
National Provider Identifier
1316407190
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
544880 Issued in NY
Practice address
19 Zugibe CT
West Haverstraw, NY 10993-1242
Phone
(770) 880-4465
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 544880 NY Primary

Addresses

Primary practice location

19 Zugibe CT
West Haverstraw, NY 10993-1242

Mailing address

19 Zugibe CT
West Haverstraw, NY 10993-1242

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
544880NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1316407190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ZUGIBE CT",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 ZUGIBE CT",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931242",
            "telephone_number": "770-880-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREZEAU",
        "first_name": "SHASSAGNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "544880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haverstraw, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.