Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Philip John Mazzullo Jr.

Individual provider Registered Nurse · NPI 1205705365

Philip John Mazzullo Jr. is a Registered Nurse in Brentwood, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2025

Practice location Address checks out

998 Crooked Hill Rd
Brentwood, NY 11717-1019
Phone: (631) 834-5202
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence N02673 (NY)

Record details

NPI number1205705365
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 5, 2025
Last updated in NPPESNovember 5, 2025
Certification dateNovember 5, 2025

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