Anisa Ms Hazelwood, MS

Primary specialty

SpecialistTaxonomy code 174400000X

License

846148141 Issued in NY

Practice address

100 Dixon Ave
Copiague, NY 11726-1905

Phone

(631) 491-1278

NPI assigned

May 31, 2018

Last updated

May 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1932691417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DIXON AVE",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117261905",
            "telephone_number": "631-491-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DIXON AVE",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117261905",
            "telephone_number": "631-491-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELWOOD",
        "first_name": "ANISA",
        "middle_name": "MS",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "846149141",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "846148141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Copiague, NY
• Providers in Copiague, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.