Individual provider Active NPI

Doris Azornu

  • Psychiatric/Mental Health Registered Nurse
  • Brentwood, NY
National Provider Identifier
1902399173
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
621534-1 Issued in NY
Practice address
30 Park Ave
Brentwood, NY 11717-3642
Phone
(631) 745-3917
NPI assigned
Jun 12, 2018
Last updated
Jun 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 621534-1 NY Primary

Addresses

Primary practice location

30 Park Ave
Brentwood, NY 11717-3642

Mailing address

30 Park Ave
Brentwood, NY 11717-3642
Phone (631) 745-3917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
621534-1NYMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Associations of New York State, Inc. Current Accepting new patients
Hands of Hope Mental Healthcare Psychiatric/Mental Health Current Accepting new patients
Metro Community Health Centers, Inc. CurrentSince May 2, 2022 Accepting new patients
Metro Community Health Centers, Inc. Current Accepting new patients
Metro Community Health Centers, Inc. CurrentSince May 2, 2022 Accepting new patients

Locations

979 Cross Bronx Expy
Bronx, NY 10460
Phone 71866575653009

177 Livingston St
Lowr
Brooklyn, NY 11201
Phone (718) 855-7707

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1902399173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117173642",
            "telephone_number": "631-745-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117173642",
            "telephone_number": "631-745-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZORNU",
        "first_name": "DORIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "621534-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

Verify at the official NPI Registry.