Individual provider Active NPI

Anthony Piccillo, D.C.

  • Chiropractor
  • Watchung, NJ
National Provider Identifier
1609246172
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00731100 Issued in NJ
Practice address
459 Watchung Ave
Watchung, NJ 07069-4945
Phone
(908) 756-2424
Fax
(908) 756-2447
NPI assigned
Sep 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00731100 NJ Primary

Addresses

Primary practice location

459 Watchung Ave
Watchung, NJ 07069-4945

Mailing address

10 Johnston Dr
Watchung, NJ 07069-4905
Phone (908) 756-2424

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
38MC00731100NJMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1609246172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 JOHNSTON DR",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070694905",
            "telephone_number": "908-756-2424",
            "fax_number": "908-756-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 WATCHUNG AVE",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070694945",
            "telephone_number": "908-756-2424",
            "fax_number": "908-756-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCILLO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-28",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00731100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watchung, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.