Individual provider Active NPI

Maria Lynne Ciardiello, F.N.P

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1962771212
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
333715 Issued in NY
Practice address
774 Manor Rd
Staten Island, NY 10314-7038
Phone
(718) 496-2542
Fax
(718) 494-6572
NPI assigned
Dec 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 333715 NY Primary

Addresses

Primary practice location

774 Manor Rd
Staten Island, NY 10314-7038

Mailing address

63 Potter Ave
Staten Island, NY 10314-2507
Phone (718) 727-0261

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
333715NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1962771212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 POTTER AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103142507",
            "telephone_number": "718-727-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 MANOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147038",
            "telephone_number": "718-496-2542",
            "fax_number": "718-494-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIARDIELLO",
        "first_name": "MARIA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "F.N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-15",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333715",
            "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 15, 2011; 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.