Individual provider Active NPI

Fabio Murillo, LAC

  • Acupuncturist
  • Glen Cove, NY
National Provider Identifier
1801319702
Registry record updated Jul 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
005474 Issued in NY
Practice address
70 Glen St Ste 380
Glen Cove, NY 11542-2858
Phone
(516) 852-1821
NPI assigned
Jul 23, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 005474 NY Primary

Addresses

Primary practice location

70 Glen St Ste 380
Glen Cove, NY 11542-2858

Mailing address

15 Candy LN
Syosset, NY 11791-4909
Phone (516) 852-1821

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
005474NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500768000000",
    "number": "1801319702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CANDY LN",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914909",
            "telephone_number": "516-852-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN ST STE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422858",
            "telephone_number": "516-852-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURILLO",
        "first_name": "FABIO",
        "name_prefix": "Mr.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-23",
        "last_updated": "2017-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "005474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2017; 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.