Individual provider Active NPI

Anthony Vernillo, D.D.S., PH.D., MBE

  • Oral and Maxillofacial Pathology Dentistry
  • New York, NY
National Provider Identifier
1649492406
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
033365-1 Issued in NY
Practice address
345 E 24TH St
838 Schwartz
New York, NY 10010-4020
Phone
(121) 299-8985
NPI assigned
May 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 033365-1 NY Primary

Addresses

Primary practice location

345 E 24TH St
838 Schwartz
New York, NY 10010-4020

Mailing address

3236 46TH St
Long Island City, NY 11103-1912
Phone (171) 877-7910

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
033365-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649492406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 46TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111031912",
            "telephone_number": "171-877-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E 24TH ST",
            "address_2": "838 SCHWARTZ",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104020",
            "telephone_number": "121-299-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNILLO",
        "first_name": "ANTHONY",
        "credential": "D.D.S., PH.D., MBE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "033365-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • 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.