Jenny Marie Portuallo

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1 Oakside Rd
Smithtown, NY 11787-1555

Phone

(631) 672-4185

NPI assigned

Oct 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jenny Marie Marino Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1184266256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OAKSIDE RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871555",
            "telephone_number": "631-672-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OAKSIDE RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871555",
            "telephone_number": "631-672-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTUALLO",
        "first_name": "JENNY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "MARINO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronald Pollock, L.C.S.W.
• Taylor Pollock
• Christine R Porter, LMT
• Alberta Portigiani, NP
• Portion Controller, Inc.
• Natalia Posada, MS OTR/L
• Kelsey A Pottetti
• David Powers, LCSW
• Matthew Prager
• Neazul Mowla Prantic, RN

• Specialist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.