Individual provider Active NPI

Chris Robert Muscolo

  • Specialist
  • Levittown, NY
National Provider Identifier
1902160765
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
723454 Issued in NY
Practice address
2900 Hempstead Tpke
Levittown, NY 11756-1404
Phone
(631) 366-3876
NPI assigned
Jun 26, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 723454 NY Primary

Addresses

Primary practice location

2900 Hempstead Tpke
Levittown, NY 11756-1404

Mailing address

762 Erie St
Ronkonkoma, NY 11779-6051

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
723454NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1902160765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 ERIE ST",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 HEMPSTEAD TPKE",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561404",
            "telephone_number": "631-366-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSCOLO",
        "first_name": "CHRIS",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "723454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.