Active NPI
Marisa Petagno
- Medical-Surgical Registered Nurse
- White Plains, NY
National Provider Identifier
1538805759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 738443
- Practice address
- 5 South Broadway
4TH Floor
White Plains, NY 10601 - Phone
- (914) 293-5001
- NPI assigned
- May 10, 2022
- Last updated
- May 10, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 738443 | NJ | Primary |
Addresses
Primary practice location
5 South Broadway
4TH Floor
White Plains, NY 10601
Mailing address
135 Orchard Park
Allendale, NJ 07401
Phone (201) 316-3282
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 |
|---|---|---|---|
| 738443 | NJ | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652140800000",
"number": "1538805759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 ORCHARD PARK",
"city": "ALLENDALE",
"state": "NJ",
"postal_code": "07401",
"telephone_number": "201-316-3282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 SOUTH BROADWAY",
"address_2": "4TH FLOOR",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "10601",
"telephone_number": "914-293-5001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETAGNO",
"first_name": "MARISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-10",
"last_updated": "2022-05-10",
"certification_date": "2022-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "NJ",
"license": "738443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.