MEDICARE: MR. JOHN CHARLES AZZOPARDI RN,MSN,CNS

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	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	R01051	NY
2	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	R01051	NY

General Provider Information

NPI Number	:	1306043203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN CHARLES AZZOPARDI RN,MSN,CNS

Provider Business Mailing Address
First Line	:	220 E 87TH ST
Second Line	:	OFFICE SUITE L.A.
City	:	NEW YORK
State	:	NY
Zip	:	10128-3127
Country	:	US
Telephone Number	:	212-410-0541
Fax Number	:	212-410-0541

Provider Business Practice Location Address
First Line	:	220 E 87TH ST
Second Line	:	OFFICE SUITE L.A.
City	:	NEW YORK
State	:	NY
Zip	:	10128-3127
Country	:	US
Telephone Number	:	212-410-0541
Fax Number	:	212-410-0541

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

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	09/11/2025

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