Gabrielle Luisa Massucci, MS CF-SLP TSSLD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

299 Hallock Ave
Port Jefferson Station, NY 11776-1217

Phone

(631) 473-4284

NPI assigned

Aug 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1497366918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 AVENUE C",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117791945",
            "telephone_number": "631-901-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761217",
            "telephone_number": "631-473-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSUCCI",
        "first_name": "GABRIELLE",
        "middle_name": "LUISA",
        "name_prefix": "Ms.",
        "credential": "MS CF-SLP TSSLD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Amalia Marzullo-Manez, M.S.
• Adelaide Lu Masakayan, M.D.
• Brandon Theodore Maslosky, L.P.N.
• Jade Maslosky, REGISTERED NURSE
• Felicity Joy Masone
• Kristyn Leigh Mastridge
• Andrew Vincent Mastronardi, DMD
• Paul Mastrorocco, DISPENSING OPTICIAN
• Kenneth Ryan Mataragas, PA-C
• Mather Faculty Medical Affiliates, University Faculty Practice Corp

• Student in an Organized Health Care Education/Training Program in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.