Active NPI
Vincent John Dicostanzo, DC
- Chiropractor
- Orangeburg, NY
National Provider Identifier
1629122650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X2720
- Practice address
- 450 Western Highway
Suite C
Orangeburg, NY 10962 - Phone
- (845) 359-1303
- Fax
- (845) 359-1457
- NPI assigned
- Jan 23, 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 | X2720 | NY | Primary |
Addresses
Primary practice location
450 Western Highway
Suite C
Orangeburg, NY 10962
Mailing address
450 Western Highway
Suite C
Orangeburg, NY 10962
Phone (845) 359-1303
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 |
|---|---|---|---|
| X2720 | NY | MD | Chiropractor |
| 002720 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479254400000",
"number": "1629122650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 WESTERN HIGHWAY",
"address_2": "SUITE C",
"city": "ORANGEBURG",
"state": "NY",
"postal_code": "10962",
"telephone_number": "845-359-1303",
"fax_number": "845-359-1457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 WESTERN HIGHWAY",
"address_2": "SUITE C",
"city": "ORANGEBURG",
"state": "NY",
"postal_code": "10962",
"telephone_number": "845-359-1303",
"fax_number": "845-359-1457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICOSTANZO",
"first_name": "VINCENT",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2016-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X2720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orangeburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.