Provider Demographics
NPI:1831242122
Name:MUSCOLINO, PAUL A (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:MUSCOLINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 WILMOT RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-725-4844
Mailing Address - Fax:914-725-8214
Practice Address - Street 1:1024 WILMOT RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-725-4844
Practice Address - Fax:914-725-8214
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYOO37441111NN1001X
NYX521111N00000X
FL1341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NN1001XChiropractic ProvidersChiropractorNutrition
Not Answered111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX06472Medicare ID - Type Unspecified