Individual provider Active NPI

Mezida Lazare I

  • Registered Nurse
  • Amityville, NY
National Provider Identifier
1962696518
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4505921 Issued in NY
Practice address
38 Parkway Ave
Amityville, NY 11701-1310
Phone
(631) 789-6538
NPI assigned
Aug 28, 2007
Last updated
Aug 28, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4505921 NY Primary

Addresses

Primary practice location

38 Parkway Ave
Amityville, NY 11701-1310

Mailing address

38 Parkway Ave
Amityville, NY 11701-1310
Phone (631) 789-6538

Other identifiers 1

IdentifierTypeStateIssuer
02323242MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
4505921NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1962696518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 PARKWAY AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011310",
            "telephone_number": "631-789-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 PARKWAY AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117011310",
            "telephone_number": "631-789-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARE",
        "first_name": "MEZIDA",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "4505921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02323242",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.