Individual provider Active NPI

Joseph Andolino

  • Licensed Practical Nurse
  • West Henrietta, NY
National Provider Identifier
1679970339
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
319084-1 Issued in NY
Practice address
661 Shore Dr
West Henrietta, NY 14586-9604
Phone
(585) 880-4129
NPI assigned
Nov 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 319084-1 NY Primary

Addresses

Primary practice location

661 Shore Dr
West Henrietta, NY 14586-9604

Mailing address

661 Shore Dr
West Henrietta, NY 14586-9604

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
319084-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1679970339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 SHORE DR",
            "city": "WEST HENRIETTA",
            "state": "NY",
            "postal_code": "145869604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 SHORE DR",
            "city": "WEST HENRIETTA",
            "state": "NY",
            "postal_code": "145869604",
            "telephone_number": "585-880-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDOLINO",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "319084-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Henrietta, NY

Sources for this page

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