Anna G. Custodio, AGPCNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F309861-01 Issued in NY

Practice address

480 Main St Apt 3G
New York, NY 10044-0406

Phone

(845) 521-2887

NPI assigned

Sep 16, 2020

Last updated

Sep 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1275149106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 MAIN ST APT 3G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100440406",
            "telephone_number": "845-521-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MAIN ST APT 3G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100440406",
            "telephone_number": "845-521-2887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 East 73rd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10044",
            "country_code": "US",
            "telephone_number": "646-608-3824",
            "fax_number": "646-227-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSTODIO",
        "first_name": "ANNA",
        "middle_name": "G.",
        "name_prefix": "Ms.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "604515",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F309861-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Cusick
• Dana Cusick, RN
• Tara Cuskley, PSY. D
• Karl Richard Custer II, LMSW
• Christie Lauren Custodio-Lumsden, PHD, MS, RD, CDN
• Christian M Custodio, MD
• Escarle Custodio, NP
• Custom Healthcare Solutions
• Customer Marketing Group
• Catherine Rita Cusumano, L.AC., M.S.

• Primary Care Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.