Individual provider Active NPI

Paul Nuccio, DC

  • Chiropractor
  • North Baldwin, NY
National Provider Identifier
1164512919
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005234 Issued in NY
Practice address
2089 Grand Ave
North Baldwin, NY 11510-2916
Phone
(516) 623-2100
Fax
(516) 623-0513
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005234 NY Primary

Addresses

Primary practice location

2089 Grand Ave
North Baldwin, NY 11510-2916

Mailing address

2089 Grand Ave
North Baldwin, NY 11510-2916
Phone (516) 623-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005234NYMDChiropractor
005234NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164512919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 GRAND AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102916",
            "telephone_number": "516-623-2100",
            "fax_number": "516-623-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 GRAND AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102916",
            "telephone_number": "516-623-2100",
            "fax_number": "516-623-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCCIO",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Baldwin, NY

Sources for this page

  • 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.