Active NPI
Anthony Louis Petillo, RPH
- Pharmacist
- New York, NY
National Provider Identifier
1326221839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 035071-1
- Practice address
- 931 Lexington Ave
New York, NY 10065-5771 - Phone
- (212) 794-7200
- Fax
- (212) 794-7230
- NPI assigned
- Dec 7, 2007
- Last updated
- Dec 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 035071-1 | NY | Primary |
Addresses
Primary practice location
931 Lexington Ave
New York, NY 10065-5771
Mailing address
20 Pine Hollow LN
Greenlawn, NY 11740-2208
Phone (917) 837-4158
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035071-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metro Drugs 3Rd Ave Corp | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196985600000",
"number": "1326221839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 PINE HOLLOW LN",
"city": "GREENLAWN",
"state": "NY",
"postal_code": "117402208",
"telephone_number": "917-837-4158",
"fax_number": "212-794-7230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "931 LEXINGTON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100655771",
"telephone_number": "212-794-7200",
"fax_number": "212-794-7230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETILLO",
"first_name": "ANTHONY",
"middle_name": "LOUIS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-07",
"last_updated": "2007-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "035071-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.