Nistico, Justin Anthony

Nistico, Justin Anthony is an individual health care provider with primary practice located at 602 Ivy St Fl 1 , Elmira NY 14905-1646. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Nistico, Justin Anthony can be contacted via phone (607) 737-4577.

Contact Information

Primary practice address
602 Ivy St Fl 1 Elmira NY 14905-1646
Phone: (607) 737-4577
Fax: (607) 367-5010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 277019 New York
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 277019 New York

Profile Details

NPI number 1477819951
LBN Legal business name Nistico, Justin Anthony
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2012
Last updated Nov 25th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477819951 NPPES
New York MEDICAID 04209610
New York MEDICAID 103467400

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