Cheyenne Mazza

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00957400 Issued in NJ

Practice address

1 Main St Ste 505
Eatontown, NJ 07724-3903

Phone

(732) 493-3100

NPI assigned

Mar 23, 2021

Last updated

Mar 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1477139988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAIN ST STE 505",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST STE 505",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243903",
            "telephone_number": "732-493-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZA",
        "first_name": "CHEYENNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025185",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC017413",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00957400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepa Mathew, D.O.
• Shaniyah Nicole Matthews, LAC
• Charles Mattina, M.D.
• Stephanie Julia May
• Keith Mazanowski, DC
• Elaine McCarron, PT,OT
• Emmi McCauley, LAC
• Michael A McNeill
• Kristen Lee McQueen
• Mdo Optical, Inc (Cohen's Fashion Optical)

• Occupational Therapist in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.