Organization Active NPI

Personalized Prescriptions Inc.

  • Specialty Pharmacy
  • Deer Park, NY
National Provider Identifier
1669366670
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
PERSONALIZED PRESCRIPTIONS INC.
Practice address
60 E Industry CT Ste 1B
Deer Park, NY 11729-4714
Phone
(631) 940-8880
Fax
(631) 940-8770
NPI assigned
Jun 4, 2025
Reactivated
Nov 13, 2025
Last updated
Nov 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Gene Pullo
Title
President and Ceo
Phone
(631) 940-8880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X NU Primary

Addresses

Primary practice location

60 E Industry CT Ste 1B
Deer Park, NY 11729-4714

Mailing address

60 E Industry CT Ste 1B
Deer Park, NY 11729-4714
Phone (631) 940-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220819000611 NY Part B Supplier - Pharmacy 8527319599 Practice locations: Deer Park, NY

National Provider Directory

National Provider Directory

Locations

60 E Industry Ct
Ste 1B
Deer Park, NY 11729
Phone (631) 940-8880

60 E Industry Ct
Ste 4B
Deer Park, NY 11729
Phone (631) 940-8880

NPI Registry JSON

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1669366670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 E INDUSTRY CT STE 1B",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294714",
            "telephone_number": "631-940-8880",
            "fax_number": "631-940-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 E INDUSTRY CT STE 1B",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117294714",
            "telephone_number": "631-940-8880",
            "fax_number": "631-940-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED PRESCRIPTIONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-11-13",
        "certification_date": "2025-06-04",
        "deactivation_date": "2025-10-27",
        "reactivation_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "PULLO",
        "authorized_official_first_name": "GENE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "631-940-8880"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.