ROBERT FREDERICK MAZZEO (NPI# 1043240534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043240534 |
| Entity Type | Individual |
| Full Name | ROBERT FREDERICK MAZZEO |
| Credential | MD |
| Practice Address |
640 Hawkins Ave Lake Ronkonkoma NY 11779-2324 |
| Mailing Address |
55 Water Street 2nd Floor Cred Dept New York NY 10041-0004 |
| Practice Telephone | 6317370100 |
| Practice Fax Number | 6317370100 |
| Mailing Telephone | 6466802888 |
| Mailing Fax Number | 5165425556 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-09-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 162565 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1120 Little East Neck Road, West Babylon, NY 11704 | 6316697712 | 6316697718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417991977 | Robert J Mazzeo | Surgery | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2006-06-15 |
| Street Address |
640 HAWKINS AVE |
| City | LAKE RONKONKOMA |
| State | NY |
| Zip Code | 11779-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871546812 | Mohinder K Guram | Pediatrics | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2006-05-19 |
| 1962734541 | Long Island, Queens Hearing Asso Inc | Hearing Aid Equipment | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2010-02-05 |
| 1023349115 | Joseph Patrick Frank | Pharmacist | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2010-01-29 |
| 1619203262 | Eyecare Advantage, Inc. | Eyewear Supplier (Equipment, not the service) | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2009-11-02 |
| 1023245479 | Tara K Singh | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2009-06-12 |
| 1992903264 | Manish Chadha | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2007-07-06 |
| 1033315775 | Diana Kaplinsky | Internal Medicine | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2007-06-21 |
| 1912109604 | Salma Afroze | Obstetrics & Gynecology | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2007-06-04 |
| 1124247432 | Emblemhealth Services Company | Pharmacy | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2007-04-25 |
| 1821135567 | Andrew William Caradona | Pharmacist | 640 Hawkins Ave, Lake Ronkonkoma, NY 11779-2324 | 2007-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487656740 | Manuel R Rosales | Family Medicine | 388 Hawkins Ave, Ste 1, Lake Ronkonkoma, NY 11779-4280 | 2005-06-01 |
| 1841553310 | Nina Malika Hicks | Family Medicine | 122 Portion Rd, Lake Ronkonkoma, NY 11779-4174 | 2012-06-20 |
| 1912024506 | Michael Creta, Do | Family Medicine | 290 Hawkins Ave, Lake Ronkonkoma, NY 11779-9600 | 2007-03-26 |
| 1518082080 | Ismail Ozcan Md PC | Family Medicine | 95 Church St, Lake Ronkonkoma, NY 11779-4159 | 2007-03-21 |
| 1639233901 | Theodore Fried Burford Welch & David Hauer Md, PC | Family Medicine | 388 Hawkins Ave, Suite 1, Lake Ronkonkoma, NY 11779-4280 | 2006-12-21 |
| 1346242690 | Jack Z Nussbaum | Family Medicine | 388 Hawkins Ave, Ste 1, Lake Ronkonkoma, NY 11779-4280 | 2005-06-01 |
| 1518969880 | David I Hauer | Family Medicine | 388 Hawkins Ave, Ste 1, Lake Ronkonkoma, NY 11779-4280 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1336749571 | Chowdhury Medical PC | Family Medicine | 155 Alkier St, Brentwood, NY 11717-5129 | 2020-10-27 |
| 1356940084 | Rebecca Jean Smouse | Family Medicine | 1107 Prendergast Ave, Jamestown, NY 14701-3315 | 2020-10-23 |
| 1336748136 | Rapha House Calls | Family Medicine | 2 Fernglade Ct, Chester, NY 10918-2637 | 2020-10-22 |
| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | LAKE RONKONKOMA |
| Zip Code | 11779 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.