National Provider Identifier

Justin Anthony Nistico, D.O.

Justin Anthony Nistico, D.O. is listed in the NPPES registry with a primary specialty of Infectious Disease Physician in Elmira, NY and a listed phone number of (607) 737-4577.

NPI 1477819951Elmira, NYInfectious Disease Physician

Profile Overview

NPI
1477819951
Provider Type
Individual
Primary Specialty
Infectious Disease Physician
Enumeration Date
April 09, 2012
Last Updated
November 25, 2020

Practice Location

  • 602 Ivy St Fl 1
  • Elmira, NY 14905-1646

Phone: (607) 737-4577

Mailing Address

  • 571 Saint Josephs Blvd
  • Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Infectious Disease Physician (207RI0200X)
  • Internal Medicine Physician (207R00000X)
Full Record
NPI
1477819951
Entity Type
Individual
Last Name
Nistico
First Name
Justin
Middle Name
Anthony
Name Prefix
Dr.
Credential
D.O.
Mailing Street Address
571 Saint Josephs Blvd
Mailing Address Line 2
Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2050
Practice Street Address
602 Ivy St Fl 1
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14905-1646
Practice Country
US
Practice Phone
(607) 737-4577
Practice Fax
(607) 367-5010
Enumeration Date
April 09, 2012
Last Updated
November 25, 2020
Sex
Male
Sole Proprietor
No
Certification Date
November 25, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Infectious Disease Physician (207RI0200X), Internal Medicine Physician (207R00000X)
Other Identifiers
04209610 (NY), 103467400 (PA)