Active NPI
Stephanie Blanche Mustico, PHARMD
- Pharmacist
- Elmira, NY
National Provider Identifier
1194997221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051079
- Practice address
- 1100 Clemens Center Pkwy
Attn: Pharmacy Manager
Elmira, NY 14901-1563 - Phone
- (607) 737-5090
- Fax
- (637) 737-5067
- NPI assigned
- Mar 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051079 | NY | Primary |
Addresses
Primary practice location
1100 Clemens Center Pkwy
Attn: Pharmacy Manager
Elmira, NY 14901-1563
Mailing address
1500 Brooks Ave
Attn: Pharmacy Manager
Rochester, NY 14624-3512
Phone (585) 239-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051079 | Other | NY | PHARMACIST LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051079 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492732800000",
"number": "1194997221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 BROOKS AVE",
"address_2": "ATTN: PHARMACY MANAGER",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146243512",
"telephone_number": "585-239-2020",
"fax_number": "585-239-2015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 CLEMENS CENTER PKWY",
"address_2": "ATTN: PHARMACY MANAGER",
"city": "ELMIRA",
"state": "NY",
"postal_code": "149011563",
"telephone_number": "607-737-5090",
"fax_number": "637-737-5067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSTICO",
"first_name": "STEPHANIE",
"middle_name": "BLANCHE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-28",
"last_updated": "2017-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "051079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "051079",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmira, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.