Active NPI
Mia Kristen Frezzo, DVM
- Veterinarian
- Paramus, NJ
National Provider Identifier
1619120920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 29V100453700
- Practice address
- 60 S. RT. 17 North
Paramus, NJ 07652 - Phone
- (201) 845-5575
- Fax
- (201) 845-5576
- NPI assigned
- Oct 30, 2008
- 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 |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 29V100453700 | NJ | Primary |
Addresses
Primary practice location
60 S. RT. 17 North
Paramus, NJ 07652
Mailing address
60 S. RT. 17 North
Paramus, NJ 07652
Phone (201) 845-5575
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 |
|---|---|---|---|
| 29V100453700 | NJ | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225324800000",
"number": "1619120920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 S. RT. 17 NORTH",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "07652",
"telephone_number": "201-845-5575",
"fax_number": "201-845-5576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 S. RT. 17 NORTH",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "07652",
"telephone_number": "201-845-5575",
"fax_number": "201-845-5576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREZZO",
"first_name": "MIA",
"middle_name": "KRISTEN",
"name_prefix": "Dr.",
"credential": "DVM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-30",
"last_updated": "2008-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "NJ",
"license": "29V100453700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paramus, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.