Active NPI
Alfred S Costanzo, DC
- Chiropractor
- Danbury, CT
National Provider Identifier
1497961569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CT000747
- Practice address
- 191 Main St
Danbury, CT 06810-6614 - Phone
- (203) 748-4800
- Fax
- (203) 748-1239
- NPI assigned
- May 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CT000747 | CT | Primary |
Addresses
Primary practice location
191 Main St
Danbury, CT 06810-6614
Mailing address
191 Main St
Danbury, CT 06810-6614
Phone (203) 748-4800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P463970 | Other | CT | OXFORD |
| 506594 | Other | CT | AETNA |
| 050000747CT02 | Other | CT | ANTHEM BLUE CROSS BLUE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CT000747 | CT | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497961569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 MAIN ST",
"city": "DANBURY",
"state": "CT",
"postal_code": "068106614",
"telephone_number": "203-748-4800",
"fax_number": "203-748-1239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 MAIN ST",
"city": "DANBURY",
"state": "CT",
"postal_code": "068106614",
"telephone_number": "203-748-4800",
"fax_number": "203-748-1239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTANZO",
"first_name": "ALFRED",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CT",
"license": "CT000747",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P463970",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "506594",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE",
"identifier": "050000747CT02",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Danbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.