Jasmina Fajic-Mattioli

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

307419 Issued in NY

Practice address

234 Fox Run Lane
Carmel, NY 10512

Phone

(914) 482-4820

NPI assigned

Oct 24, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1346526225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 FOX RUN LANE",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "10512",
            "telephone_number": "914-482-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 FOX RUN LANE",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "10512",
            "telephone_number": "914-482-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJIC-MATTIOLI",
        "first_name": "JASMINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-24",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "307419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Lynn Enkler, PHARMD
• Eos Medical Group PC
• Eos Medical Group PC
• Kimberly Everett
• Adrienne Lucia Fabrizio, D.C.
• Allan Howard Farquhar, M.D.
• Lindsey B Farrelly, MSW
• Maureen Siobhan Farrelly, LPN
• Frank Fasano, PA
• Douglas Fauser, MD

• Licensed Practical Nurse in Carmel, NY
• Providers in Carmel, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; 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.