Active NPI
Paulette Pettorino, LAC
- Acupuncturist
- Ny, NY
National Provider Identifier
1740498864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 000287
- Practice address
- 1133 Broadway
# 1016
Ny, NY 10010 - Phone
- (212) 982-1245
- Fax
- (212) 982-1245
- NPI assigned
- May 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 000287 | NY | Primary |
Addresses
Primary practice location
1133 Broadway
# 1016
Ny, NY 10010
Mailing address
231 Thompson St
# 18
Ny, NY 10012
Phone (212) 473-1837
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000287 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740498864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 THOMPSON ST",
"address_2": "# 18",
"city": "NY",
"state": "NY",
"postal_code": "10012",
"telephone_number": "212-473-1837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1133 BROADWAY",
"address_2": "# 1016",
"city": "NY",
"state": "NY",
"postal_code": "10010",
"telephone_number": "212-982-1245",
"fax_number": "212-982-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTORINO",
"first_name": "PAULETTE",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "000287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ny, 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.