Robert A Pezzullo, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA00383 Issued in RI

Practice address

161 W Shore Rd Apt A9
Warwick, RI 02889-1152

Phone

(401) 732-6768

NPI assigned

Mar 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679697502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 W SHORE RD APT A9",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028891152",
            "telephone_number": "401-732-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 W SHORE RD APT A9",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028891152",
            "telephone_number": "401-732-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZULLO",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "RI",
            "license": "OTA00383",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MA",
            "license": "03018",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "001008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petteruti Family Practice Inc
• Shannon Petteruti, NP-C
• Kaitlin M Petty
• Bethany A Pezza, NP
• John Albert Pezzullo III, MD
• Catherine B Phamduy
• Pharmacy Corporation of America
• Melissa Phelps, LICSW
• Kathleen M Phillips, MS RNP
• Kenneth Roswell Phillips, M.D.

• Occupational Therapy Assistant in Warwick, RI
• Providers in Warwick, RI by specialty
• Occupational Therapy Assistant in Rhode Island

• 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.