Individual provider Active NPI

Maria Fasulo

  • Registered Nurse
  • New York, NY
National Provider Identifier
1801263355
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
619932 Issued in NY
Practice address
675 3Rd Ave
New York, NY 10017-5704
Phone
(917) 297-5526
Fax
(646) 763-8425
NPI assigned
Aug 31, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 619932 NY Primary

Addresses

Primary practice location

675 3Rd Ave
New York, NY 10017-5704

Mailing address

802 70TH St
Brooklyn, NY 11228-1013

Other names 1

  • Maria Papadimitriou-Fasulo Professional name

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
619932NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1801263355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 70TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112281013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175704",
            "telephone_number": "917-297-5526",
            "fax_number": "646-763-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASULO",
        "first_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "619932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "PAPADIMITRIOU-FASULO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.