Individual provider Active NPI

Karen A Mezzullo, MA SPECIAL EDUCATION

  • Specialist
  • Port Washington, NY
National Provider Identifier
1891287843
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
42A Edgewood Rd
Port Washington, NY 11050-1531
Phone
(516) 767-8657
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY Primary

Addresses

Primary practice location

42A Edgewood Rd
Port Washington, NY 11050-1531

Mailing address

42A Edgewood Rd
Port Washington, NY 11050-1531
Phone (516) 767-8657

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891287843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42A EDGEWOOD RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501531",
            "telephone_number": "516-767-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42A EDGEWOOD RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501531",
            "telephone_number": "516-767-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZZULLO",
        "first_name": "KAREN",
        "middle_name": "A",
        "credential": "MA SPECIAL EDUCATION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.