Mary Mantegna, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

02200373904 Issued in NY

Practice address

3380 Sweden Walker Rd
Brockport, NY 14420-9430

Phone

(585) 637-9152

NPI assigned

Aug 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1283040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283040000000",
    "number": "1699081554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 SWEDEN WALKER RD",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144209430",
            "telephone_number": "585-637-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 SWEDEN WALKER RD",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144209430",
            "telephone_number": "585-637-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTEGNA",
        "first_name": "MARY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-29",
        "last_updated": "2010-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "02200373904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Dahl Maher, CNM
• Samantha Mahon
• Kimberley J. Maier, R.PH.
• Quinn Maloney
• Laurie Delores Marie Mansfield, RN
• David Gerould Markham, L.C.S.W.
• Amy Dania Mason, LMT
• Alison McAvoy, PHARM.D
• Jason McClung, MD
• Robert McClurg, FNP

• Registered Nurse in Brockport, NY
• Providers in Brockport, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2010; 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.