Paul Ericson Santiago Carillo, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40QA01235100 Issued in NJ

Practice address

9000 Fellowship Rd
Basking Ridge, NJ 07920-3912

Phone

(908) 580-3827

NPI assigned

May 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326249020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 GRANDVIEW DR",
            "city": "WEST PATERSON",
            "state": "NJ",
            "postal_code": "074242709",
            "telephone_number": "732-794-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 FELLOWSHIP RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203912",
            "telephone_number": "908-580-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARILLO",
        "first_name": "PAUL ERICSON",
        "middle_name": "SANTIAGO",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "PT40QA01235100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Camacho, FNP-BC
• Deborah Marie Capko, MD
• Ari M Carden
• Cardioimaging Diagnostics
• Daniel Walter Carey, DDS
• Lois A. Carpenter, P.T.
• Ephraim S Casper, MD
• Jillian Josephine Cassidy
• Cerebral Palsy of North Jersey
• Sophia Chadda, DDS

• Physical Therapist in Basking Ridge, NJ
• Providers in Basking Ridge, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.