Individual provider Active NPI

Emily Rose Pezzullo

  • Pharmacist
  • North Providence, RI
National Provider Identifier
1891171377
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH05468 Issued in RI
Practice address
1665 Mineral Spring Ave
North Providence, RI 02904-4003
Phone
(401) 353-3113
NPI assigned
Aug 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH05468 RI Primary

Addresses

Primary practice location

1665 Mineral Spring Ave
North Providence, RI 02904-4003

Mailing address

1665 Mineral Spring Ave
North Providence, RI 02904-4003

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

LicenseStateTypeSpecialty
RPH05468RIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1891171377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 MINERAL SPRING AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 MINERAL SPRING AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044003",
            "telephone_number": "401-353-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZULLO",
        "first_name": "EMILY",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "RPH05468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.