MEDICARE: MRS. MARY PIZZINGRILLO NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	334457	NY
2	363LA2200X	Adult Health Nurse Practitioner	301730	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215904271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY PIZZINGRILLO NP

Provider Business Mailing Address
First Line	:	11835 QUEENS BLVD STE 400
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7211
Country	:	US
Telephone Number	:	646-722-7610
Fax Number	:	347-535-3970

Provider Business Practice Location Address
First Line	:	11835 QUEENS BLVD STE 400
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-7211
Country	:	US
Telephone Number	:	646-722-7610
Fax Number	:	347-535-3970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	04/14/2025

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