Active NPI
Cheryline Pezzullo
- General Practice Dentistry
- Cortlandt Manor, NY
National Provider Identifier
1679966535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0587491
- Practice address
- 16 Wharton Dr
Cortlandt Manor, NY 10567-7431 - Phone
- (914) 729-4243
- NPI assigned
- Mar 16, 2015
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0587491 | NY | Primary |
Addresses
Primary practice location
16 Wharton Dr
Cortlandt Manor, NY 10567-7431
Mailing address
16 Wharton Dr
Cortlandt Manor, NY 10567-7431
Phone (914) 729-4243
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 |
|---|---|---|---|
| 0587491 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504742400000",
"number": "1679966535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 WHARTON DR",
"city": "CORTLANDT MANOR",
"state": "NY",
"postal_code": "105677431",
"telephone_number": "914-729-4243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 WHARTON DR",
"city": "CORTLANDT MANOR",
"state": "NY",
"postal_code": "105677431",
"telephone_number": "914-729-4243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEZZULLO",
"first_name": "CHERYLINE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-16",
"last_updated": "2017-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "0587491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cortlandt Manor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.