Carleen A Mazzie
Individual provider Active NPI Licensed Practical Nurse · Yaphank, NY
NPI 1669732020 · NPPES record last updated May 20, 2012
Key facts
- NPI
- 1669732020
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 098635 (NY)
- Practice address
- 11 Rutledge Commons
Yaphank, NY 11980-2028 - Phone
- (631) 334-5780
- NPI assigned
- May 20, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 098635 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 098635 | NY | Yes |
Addresses
Primary practice location
11 Rutledge Commons
Yaphank, NY 11980-2028
Mailing address
11 Rutledge Commons
Yaphank, NY 11980-2028
Phone (631) 334-5780
Other providers in Yaphank, NY
- Nicole Marengo
- Coryn Martin
- Emily Lynn Martino
- Maryhaven Center of Hope Inc.
- Jillian Maute
- Linda McCarthy
- Bonnie McCluskey
- Laura A McGee-Chiusano
- Rosemarie McIntyre
- Jordana D McSherry
All providers in Yaphank, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.