Individual provider Active NPI

Samantha Fustinoni

  • Hearing Instrument Specialist
  • Ithaca, NY
National Provider Identifier
1417413758
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
14000054986 Issued in NY
Practice address
2 Graham Rd W Ste 200
Ithaca, NY 14850-1055
Phone
(607) 319-4754
NPI assigned
Feb 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 14000054986 NY Primary

Addresses

Primary practice location

2 Graham Rd W Ste 200
Ithaca, NY 14850-1055

Mailing address

2 Graham Rd W Ste 200
Ithaca, NY 14850-1055
Phone (607) 319-4754

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
14000054986NYMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1417413758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GRAHAM RD W STE 200",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501055",
            "telephone_number": "607-319-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GRAHAM RD W STE 200",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501055",
            "telephone_number": "607-319-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSTINONI",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NY",
            "license": "14000054986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.