Individual provider Active NPI

Priscah Musonza

  • Specialist
  • Central Islip, NY
National Provider Identifier
1972994408
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
703380 Issued in NY
Practice address
172 Tree Ave
Central Islip, NY 11722-3546
Phone
(631) 332-8736
NPI assigned
Feb 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 703380 NY Primary

Addresses

Primary practice location

172 Tree Ave
Central Islip, NY 11722-3546

Mailing address

172 Tree Ave
Central Islip, NY 11722-3546
Phone (631) 332-8736

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
703380NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
PM Evaluation & Therapy Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1972994408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 TREE AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117223546",
            "telephone_number": "631-332-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 TREE AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117223546",
            "telephone_number": "631-332-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSONZA",
        "first_name": "PRISCAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "703380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.