Enrique Tomenio Pallesco, SUBMARINE IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

16349 Smithfield Heights Dr
Smithfield, VA 23430-7096

Phone

(757) 771-1162

NPI assigned

Mar 16, 2011

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

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1487953444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16349 SMITHIFELD HEIGHTS DRIVE",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "23430",
            "telephone_number": "757-771-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16349 SMITHFIELD HEIGHTS DR",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234307096",
            "telephone_number": "757-771-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLESCO",
        "first_name": "ENRIQUE",
        "middle_name": "TOMENIO",
        "name_prefix": "Mr.",
        "credential": "SUBMARINE IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Independent Duty Corpsman in Smithfield, VA
• Providers in Smithfield, VA by specialty
• Independent Duty Corpsman in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.