Healthcare Provider Details

I. General information

NPI: 1205751245
Provider Name (Legal Business Name): ADRIANNA RITA MUSSUMECI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W MAIN ST
BABYLON NY
11702-3425
US

IV. Provider business mailing address

122 W MAIN ST
BABYLON NY
11702-3425
US

V. Phone/Fax

Practice location:
  • Phone: 631-482-8030
  • Fax:
Mailing address:
  • Phone: 631-482-8030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP144945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: