Active NPI
Marc Cimmino DO PC
- Family Medicine Physician
- Bay Shore, NY
National Provider Identifier
1609022995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 172519
- Legal business name
- MARC CIMMINO DO PC
- Practice address
- 40 Bay Shore Ave
Bay Shore, NY 11706-7929 - Phone
- (631) 969-8700
- Fax
- (631) 969-8703
- NPI assigned
- Aug 18, 2008
- Last updated
- Sep 5, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Marc C Cimmino, D.O.
- Title
- Physician/Owner
- Phone
- (631) 969-8700
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 172519 | NY | Primary |
Addresses
Primary practice location
40 Bay Shore Ave
Bay Shore, NY 11706-7929
Mailing address
40 Bay Shore Ave
Bay Shore, NY 11706-7929
Phone (631) 969-8700
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Oakdale, NY
- NPI 1669578159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219017600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1220572800000",
"number": "1609022995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 BAY SHORE AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117067929",
"telephone_number": "631-969-8700",
"fax_number": "631-969-8703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 BAY SHORE AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117067929",
"telephone_number": "631-969-8700",
"fax_number": "631-969-8703"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARC CIMMINO DO PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-18",
"last_updated": "2008-09-05",
"status": "A",
"authorized_official_last_name": "CIMMINO",
"authorized_official_first_name": "MARC",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "631-969-8700",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "172519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.