Provider Demographics
NPI:1306043203
Name:AZZOPARDI, JOHN CHARLES (RN,MSN,CNS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHARLES
Last Name:AZZOPARDI
Suffix:
Gender:M
Credentials:RN,MSN,CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E 87TH ST
Mailing Address - Street 2:OFFICE SUITE L.A.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3127
Mailing Address - Country:US
Mailing Address - Phone:212-410-0541
Mailing Address - Fax:212-410-0541
Practice Address - Street 1:220 E 87TH ST
Practice Address - Street 2:OFFICE SUITE L.A.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3127
Practice Address - Country:US
Practice Address - Phone:212-410-0541
Practice Address - Fax:212-410-0541
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR01051364SP0808X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Not Answered364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR01051Medicare ID - Type UnspecifiedLICENSE NUMBER