Active NPI
Matthew Paul Gazzillo, CNIM
- Electroneurodiagnostic Specialist/Technologist
- Morrisville, PA
National Provider Identifier
1538660352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Electroneurodiagnostic Specialist/Technologist
- License
- 1372
- Practice address
- 201 Floral Vale Blvd
Morrisville, PA 19067-5524 - Phone
- (484) 351-8459
- Fax
- (484) 351-8810
- NPI assigned
- Feb 27, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X | 1372 | NJ | Primary |
Addresses
Primary practice location
201 Floral Vale Blvd
Morrisville, PA 19067-5524
Mailing address
201 Floral Vale Blvd
Morrisville, PA 19067-5524
Phone (215) 354-6674
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1372 | NJ | MD | Electroneurodiagnostic Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519689600000",
"number": "1538660352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 FLORAL VALE BLVD",
"city": "MORRISVILLE",
"state": "PA",
"postal_code": "190675524",
"telephone_number": "215-354-6674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 FLORAL VALE BLVD",
"city": "MORRISVILLE",
"state": "PA",
"postal_code": "190675524",
"telephone_number": "484-351-8459",
"fax_number": "484-351-8810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAZZILLO",
"first_name": "MATTHEW",
"middle_name": "PAUL",
"credential": "CNIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-02-27",
"last_updated": "2018-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "246ZE0600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": "NJ",
"license": "1372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morrisville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.