Amanda Lauren Pittillo, PA-C

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

C07081 Issued in MD

Practice address

9515 Deereco Rd Ste 208
Timonium, MD 21093-2153

Phone

(410) 449-2060

NPI assigned

Feb 27, 2019

Last updated

Feb 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1821555780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 DEERECO RD STE 208",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932153",
            "telephone_number": "410-449-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 DEERECO RD STE 208",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932153",
            "telephone_number": "410-449-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTILLO",
        "first_name": "AMANDA",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MD",
            "license": "C07081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE NUMBER",
            "identifier": "C07081",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physician Imaging of Washington Hospital Center, LLC (Medstar Radiology Network at Timonium)
• Naomi Pickett
• Pietrowski-Tsui Chiropractic P C (The Center for Advanced Physical Health)
• Colleen Pietrowski, D.C.
• Pikesville Behavioral Health Center
• PM Pediatrics of Maryland LLC
• Nadja Polston, NP
• George Poscover, PT
• Ganesh Sanjiv Prabhu, MD
• Precious Cargo Transport

• Procedural Dermatology Physician in Timonium, MD
• Providers in Timonium, MD by specialty
• Procedural Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.