NPIMap

Organization Active NPI

Mary a. Nasso DDS & Eleanor J. Olsen DDS,PC

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1962444216
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34314 Issued in NY
Legal business name
MARY A. NASSO DDS & ELEANOR J. OLSEN DDS,PC
Practice address
4546 Hylan Blvd
Staten Island, NY 10312-6400
Phone
(718) 948-5111
Fax
(718) 948-1932
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Authorized official

Name
Dr. Mary A. Nasso, DDS
Title
President
Phone
(718) 948-5111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 34314 NY Primary

Addresses

Primary practice location

4546 Hylan Blvd
Staten Island, NY 10312-6400

Mailing address

4546 Hylan Blvd
Staten Island, NY 10312-6400
Phone (718) 948-5111

National Provider Directory

National Provider Directory

Locations

4546 Hylan Blvd
Staten Island, NY 10312
Phone (718) 948-5111

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1962444216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4546 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126400",
            "telephone_number": "718-948-5111",
            "fax_number": "718-948-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4546 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126400",
            "telephone_number": "718-948-5111",
            "fax_number": "718-948-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY A. NASSO DDS & ELEANOR J. OLSEN DDS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "NASSO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-948-5111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "34314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.