OrganizationActive
Aging Well RN NP Family Health PLLC
NPI 1629202478 · Primary Care Nurse Practitioner · Staten Island, NY
Provider details
- NPI number
- 1629202478
- Entity type
- Organization
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Azza Ezzat, President(717) 716-7107
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
774 Manor Rd
Staten Island, NY 10314-7038
Phone: (718) 496-2542
Street-level locationGet directions
Mailing address
796 Rathbun Ave
Staten Island, NY 10309-2409
Additional practice locations (1)
- 1110 South Ave Ste 404Staten Island, NY 10314-3411Phone: (800) 277-4680Fax: (888) 556-9797
Registry dates
- Enumerated
- 2009-05-07
- Last updated
- 2026-04-24
- Certified
- 2026-04-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.