Active NPI
Peter R Picataggio, L.M.T
- Specialist
- Patchogue, NY
National Provider Identifier
1902061245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 11506-1
- Practice address
- 440 Waverly Ave
Suite 4
Patchogue, NY 11772-7600 - Phone
- (631) 475-6602
- Fax
- (631) 289-3142
- NPI assigned
- Jul 25, 2008
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 11506-1 | NY | Primary |
Addresses
Primary practice location
440 Waverly Ave
Suite 4
Patchogue, NY 11772-7600
Mailing address
440 Waverly Ave
Suite 4
Patchogue, NY 11772-7600
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 |
|---|---|---|---|
| 11506-1 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216944000000",
"number": "1902061245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 WAVERLY AVE",
"address_2": "SUITE 4",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117727600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 WAVERLY AVE",
"address_2": "SUITE 4",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117727600",
"telephone_number": "631-475-6602",
"fax_number": "631-289-3142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICATAGGIO",
"first_name": "PETER",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "L.M.T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-25",
"last_updated": "2008-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "11506-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.