Individual provider · Type 1 NPI

Philip John Mazzullo Jr.

Registered Nurse · Brentwood, NY

NPI number 1205705365 Active

Practice location

998 Crooked Hill Rd
Brentwood, NY 11717-1019

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse Primary 163W00000XN02673 (NY)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1205705365

Philip John Mazzullo Jr.'s National Provider Identifier is 1205705365, issued on Nov 5, 2025. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Brentwood, NY. The record was last updated on Nov 5, 2025.