NPI Code Detail JSON Logo

1205276193 NPI number — PETER STICCO MD

NPI Number: 1205276193
Health Care Provider/Practitioner: PETER STICCO MD

Information about “1205276193” NPI (PETER STICCO MD) exists in 1205276193 in HTML format HTML  |  1205276193 in plain Text format TXT  |  1205276193 in PDF (Portable Document Format) PDF  |  1205276193 in an XML format XML  formats.

NPI Number : 1205276193 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205276193",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STICCO",
    "FirstName": "PETER",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1175 PINEVILLE RD APT 14",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHATTANOOGA",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37405-2648",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "516-941-5045",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1000 N VILLAGE AVE STE 204",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROCKVILLE CENTRE",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11570-1000",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "516-705-2206",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/25/2013",
    "LastUpdateDate": "06/11/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207V00000X",
        "TaxonomyName": "Obstetrics & Gynecology Physician",
        "LicenseNumber": "303885",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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