Provider Demographics
NPI:1659729275
Name:MUSICO, CONCETTA
Entity Type:Individual
Prefix:
First Name:CONCETTA
Middle Name:
Last Name:MUSICO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 LONGDALE RD
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-3656
Mailing Address - Country:US
Mailing Address - Phone:914-620-5781
Mailing Address - Fax:
Practice Address - Street 1:51 LONGDALE RD
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-3656
Practice Address - Country:US
Practice Address - Phone:914-620-5781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency