Krystle Mary Tantillo, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

067674I Issued in NY

Practice address

71 E Old Country Rd
Hicksville, NY 11801-4200

Phone

(516) 719-5919

NPI assigned

Apr 20, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Delco Pharmacy Corp

  • Community/Retail Pharmacy
  • Hicksville, NY
  • NPI 1487181012
  NPD
• Pro Pharmacy LLC

  • Community/Retail Pharmacy
  • Hicksville, NY
  • NPI 1013510353
  NPD

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1609563527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 E OLD COUNTRY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014200",
            "telephone_number": "516-719-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 E OLD COUNTRY RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014200",
            "telephone_number": "516-719-5919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 E Old Country Rd",
            "address_purpose": "LOCATION",
            "city": "Hicksville",
            "state": "NY",
            "postal_code": "118014200",
            "country_code": "US",
            "telephone_number": "516-719-5919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANTILLO",
        "first_name": "KRYSTLE",
        "middle_name": "MARY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "067674I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syljan Drug Corp
• Anika Tabassum, CCC-SLP
• Maria Talavera
• Cassandra Tan, MA
• Jessica Tannacore, LMSW, CASAC-T
• Hemaila Shanzeh Tariq
• Patricia J. Tassinari, MD
• Gabriel Taub, O.D.
• Heather Taylor
• Lynda D Temple, LCSW CASAC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.