Individual provider Active NPI

Allyson Petruzziello, APN

  • Nurse Practitioner
  • Saddle Brook, NJ
National Provider Identifier
1619490083
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00696000 Issued in NJ
Practice address
289 Market St Ste 2
Saddle Brook, NJ 07663-6026
Phone
(973) 754-4797
NPI assigned
Jul 18, 2017
Last updated
May 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00696000 NJ Primary
Gerontology Nurse Practitioner 363LG0600X 26NJ00696000 NJ

Addresses

Primary practice location

289 Market St Ste 2
Saddle Brook, NJ 07663-6026

Mailing address

703 Main St
Paterson, NJ 07503-2691
Phone (973) 754-2000

Other practice location 1

299 Market St Ste 110
Saddle Brook, NJ 07663-0001
Phone (973) 754-4797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00696000NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Nurse Practitioner PastSince Mar 13, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1619490083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032691",
            "telephone_number": "973-754-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 MARKET ST STE 2",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076636026",
            "telephone_number": "973-754-4797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "299 Market St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Saddle Brook",
            "state": "NJ",
            "postal_code": "076630001",
            "country_code": "US",
            "telephone_number": "973-754-4797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRUZZIELLO",
        "first_name": "ALLYSON",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00696000",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00696000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saddle Brook, NJ

Sources for this page

Verify at the official NPI Registry.