Active NPI
Anthony Petrillo, RPH
- Pharmacist
- Newton, MA
National Provider Identifier
1679201453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH240652
- Practice address
- 103 Union St
Newton, MA 02459-2201 - Phone
- (617) 928-8455
- Fax
- (617) 928-8456
- NPI assigned
- Aug 10, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH240652 | MA | Primary |
Addresses
Primary practice location
103 Union St
Newton, MA 02459-2201
Mailing address
103 Union St
Newton, MA 02459-2201
Phone (617) 928-8455
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH240652 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union Pharmacy, LLC | Current | Accepting new patients | |
| Union Pharmacy, LLC | Past | Accepting new patients |
Locations
103 Union St
Newton Centre, MA 02459
Phone (617) 304-7477
Organizations & group practices 2
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.
-
- Long Term Care Pharmacy
- Newton, MA
- NPI 1700584141
-
- Pharmacy
- Newton Center, MA
- NPI 1952860801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660089600000",
"number": "1679201453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 UNION ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024592201",
"telephone_number": "617-928-8455",
"fax_number": "617-928-8456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 UNION ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024592201",
"telephone_number": "617-928-8455",
"fax_number": "617-928-8456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRILLO",
"first_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-10",
"last_updated": "2022-08-10",
"certification_date": "2022-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH240652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.