Individual provider Active NPI

Andrea M Dalzell

  • School Registered Nurse
  • New York, NY
National Provider Identifier
1659922193
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
746367 Issued in NY
Practice address
25 Pine St
New York, NY 10005-1001
Phone
(646) 649-3913
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 746367 NY Primary

Addresses

Primary practice location

25 Pine St
New York, NY 10005-1001

Mailing address

3914 Avenue I
Brooklyn, NY 11210-4432
Phone (347) 495-4454

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

LicenseStateTypeSpecialty
746367NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1659922193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 AVENUE I",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112104432",
            "telephone_number": "347-495-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PINE ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100051001",
            "telephone_number": "646-649-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALZELL",
        "first_name": "ANDREA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "746367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.