Individual provider Active NPI

Jennifer Mazzetti, LPN

  • Licensed Practical Nurse
  • Pleasant Valley, NY
National Provider Identifier
1710132071
Registry record updated Nov 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
10257874 Issued in NY
Practice address
2 Wilbur Rd
Pleasant Valley, NY 12569-7806
Phone
(203) 543-8459
NPI assigned
Nov 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 10257874 NY Primary

Addresses

Primary practice location

2 Wilbur Rd
Pleasant Valley, NY 12569-7806

Mailing address

2 Wilbur Rd
Pleasant Valley, NY 12569-7806
Phone (203) 543-8459

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
10257874NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1227830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227830400000",
    "number": "1710132071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WILBUR RD",
            "city": "PLEASANT VALLEY",
            "state": "NY",
            "postal_code": "125697806",
            "telephone_number": "203-543-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WILBUR RD",
            "city": "PLEASANT VALLEY",
            "state": "NY",
            "postal_code": "125697806",
            "telephone_number": "203-543-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZETTI",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-28",
        "last_updated": "2008-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10257874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2008; 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.