Active NPI
Michael J. Gullotti
- Student in an Organized Health Care Education/Training Program
- Allentown, PA
National Provider Identifier
1891920344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 1018830
- Practice address
- 301 N 4TH St
Allentown, PA 18102-3007 - Phone
- (610) 437-4601
- NPI assigned
- May 27, 2009
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 1018830 | PA | Primary |
Addresses
Primary practice location
301 N 4TH St
Allentown, PA 18102-3007
Mailing address
639 W Glenside Ave
Glenside, PA 19038-2101
Phone (215) 694-3923
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 |
|---|---|---|---|
| 1018830 | PA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1891920344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "639 W GLENSIDE AVE",
"city": "GLENSIDE",
"state": "PA",
"postal_code": "190382101",
"telephone_number": "215-694-3923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N 4TH ST",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181023007",
"telephone_number": "610-437-4601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GULLOTTI",
"first_name": "MICHAEL",
"middle_name": "J.",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-27",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "1018830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.