Active NPI
Melissa L. Trazzera, D.O.
- Adolescent Medicine (Family Medicine) Physician
- Cold Spring Harbor, NY
National Provider Identifier
1861402273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent Medicine (Family Medicine) Physician
- License
- 212705-1
- Practice address
- 470 Woodbury Rd
Cold Spring Harbor, NY 11724-2234 - Phone
- (631) 367-2013
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Adolescent Medicine (Family Medicine) Physician | 207QA0000X | 212705-1 | NY | Primary |
Addresses
Primary practice location
470 Woodbury Rd
Cold Spring Harbor, NY 11724-2234
Mailing address
470 Woodbury Rd
Cold Spring Harbor, NY 11724-2234
Phone (631) 367-2013
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01946616 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212705-1 | NY | MD | Adolescent Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212364800000",
"number": "1861402273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "470 WOODBURY RD",
"city": "COLD SPRING HARBOR",
"state": "NY",
"postal_code": "117242234",
"telephone_number": "631-367-2013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 WOODBURY RD",
"city": "COLD SPRING HARBOR",
"state": "NY",
"postal_code": "117242234",
"telephone_number": "631-367-2013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAZZERA",
"first_name": "MELISSA",
"middle_name": "L.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2008-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0000X",
"taxonomy_group": "",
"desc": "Family Medicine, Adolescent Medicine",
"state": "NY",
"license": "212705-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01946616",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cold Spring Harbor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.