Provider Demographics
NPI:1619979879
Name:MUSTO, JOSEPHINE D (FNP)
Entity Type:Individual
Prefix:MS
First Name:JOSEPHINE
Middle Name:D
Last Name:MUSTO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 5TH AVE
Mailing Address - Street 2:1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4319
Mailing Address - Country:US
Mailing Address - Phone:212-604-1300
Mailing Address - Fax:212-604-1399
Practice Address - Street 1:41 5TH AVE # 1AB
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4319
Practice Address - Country:US
Practice Address - Phone:212-604-1300
Practice Address - Fax:212-604-1399
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33-334339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1123G1Medicare PIN
NYQ45751Medicare UPIN