Individual provider Active NPI

Robyn Lazzara

  • Specialist
  • Staten Island, NY
National Provider Identifier
1669175766
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
850942 Issued in NY
Practice address
614 Yetman Ave
Staten Island, NY 10307-1826
Phone
(917) 842-6280
NPI assigned
Mar 27, 2023
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 850942 NY Primary

Addresses

Primary practice location

614 Yetman Ave
Staten Island, NY 10307-1826

Mailing address

614 Yetman Ave
Staten Island, NY 10307-1826
Phone (917) 842-6280

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
850942NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1669175766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 YETMAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071826",
            "telephone_number": "917-842-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 YETMAN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071826",
            "telephone_number": "917-842-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARA",
        "first_name": "ROBYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "850942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.