Matt Iannitelli, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

005107 Issued in NY

Practice address

551 Walnut Ave
Bohemia, NY 11716-4906

Phone

(631) 786-7832

NPI assigned

Aug 23, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1114701786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 WALNUT AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117164906",
            "telephone_number": "631-786-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 WALNUT AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117164906",
            "telephone_number": "631-786-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNITELLI",
        "first_name": "MATT",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-23",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "005107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.iannitelli@mckesson.com",
            "affiliation": "N",
            "endpointDescription": "address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "551 Walnut Ave",
            "city": "Bohemia",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117164906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Bohemia, NY
• Providers in Bohemia, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.