Individual provider Active NPI

Louis H Vastola, D.C.

  • Chiropractor
  • Great Neck, NY
National Provider Identifier
1255606877
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
002103 Issued in NY
Practice address
200 Middle Neck Rd
Great Neck, NY 11021-1107
Phone
(718) 300-8957
NPI assigned
Mar 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 002103 NY Primary

Addresses

Primary practice location

200 Middle Neck Rd
Great Neck, NY 11021-1107

Mailing address

15637 100TH St
Howard Beach, NY 11414-3238
Phone (718) 300-8957

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

State licenses

LicenseStateTypeSpecialty
002103NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1255606877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15637 100TH ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143238",
            "telephone_number": "718-300-8957",
            "fax_number": "718-374-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211107",
            "telephone_number": "718-300-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASTOLA",
        "first_name": "LOUIS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "002103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.