Carissa Lynn Agnello

Primary specialty

SpecialistTaxonomy code 174400000X

License

851929141 Issued in NY

Practice address

583 Broadhollow Rd
Suite 202
Melville, NY 11747-5017

Phone

(631) 484-8920

NPI assigned

May 3, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1992231435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 LARCH ST",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794460",
            "telephone_number": "631-484-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 BROADHOLLOW RD",
            "address_2": "SUITE 202",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475017",
            "telephone_number": "631-484-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNELLO",
        "first_name": "CARISSA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "851929141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Colon and Rectal Surgery, PC
• Advantage Massage Therapy, Chiropractic & Acupuncture, PLLC
• Advocare Inc
• Advocare, Inc.
• Carla Estefany Agama I
• Kaylee Agostinello
• Alexander J Aguera
• Sergio Aguilar Araujo
• Martha Aguilar
• Megan Jean Ahrens, DPT

• Specialist in Melville, NY
• Providers in Melville, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.