Vincent Notabartolo, DC, CCSP

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

X007822 Issued in NY

Practice address

945 Huguenot Ave
Staten Island, NY 10312-4312

Phone

(718) 317-0925

Fax

(718) 317-1533

NPI assigned

Apr 5, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104948553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 HUGUENOT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124312",
            "telephone_number": "718-317-0925",
            "fax_number": "718-317-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 HUGUENOT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124312",
            "telephone_number": "718-317-0925",
            "fax_number": "718-317-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTABARTOLO",
        "first_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "DC, CCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X007822",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "38MC00489400",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "PA",
            "license": "AJ009411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Sports Physician Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.