Enrico Petrillo, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

49975 Issued in MA

Practice address

CB Health Ventures , L.L.C.
800 Boylston St . Suite 1585
Boston, MA 02199

Phone

(617) 450-9800

NPI assigned

Feb 12, 2009

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1629217807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 STAFFORD RD",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019401462",
            "telephone_number": "617-450-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CB HEALTH VENTURES , L.L.C.",
            "address_2": "800 BOYLSTON ST . SUITE 1585",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02199",
            "telephone_number": "617-450-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLO",
        "first_name": "ENRICO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "49975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randi A Petricone, NP
• Athena Kantartzis Petrides, PH.D.
• Rachel Petrie, AUD
• Jason Petrilla
• Marielle Petrilli, RN, FNP
• Laura Anne Petrillo, MD
• Madalyn Petrillo, MD
• Desire Petrin
• Fabio Petrocca, MD
• Anya Petrof, DMD

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.