Individual provider Active NPI

Silvio Mazzella Jr., CDN

  • Nutrition Education Nutritionist
  • Bronx, NY
National Provider Identifier
1417405119
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
000961-1 Issued in NY
Practice address
711 Oakland PL
Apt H2
Bronx, NY 10457-3602
Phone
(718) 367-7270
NPI assigned
Sep 12, 2016
Last updated
Sep 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X 000961-1 NY
Nutrition Education Nutritionist 133NN1002X 000961-1 NY Primary

Addresses

Primary practice location

711 Oakland PL
Apt H2
Bronx, NY 10457-3602

Mailing address

711 Oakland Place
Apt H2
Bronx, NY 10457-3602
Phone (718) 367-7270

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
000961-1NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1417405119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 OAKLAND PLACE",
            "address_2": "APT H2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573602",
            "telephone_number": "718-367-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 OAKLAND PL",
            "address_2": "APT H2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573602",
            "telephone_number": "718-367-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZELLA",
        "first_name": "SILVIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NY",
            "license": "000961-1",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NY",
            "license": "000961-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.