Individual provider Active NPI

Denise Ann Milillo, RN

  • Registered Nurse
  • Smithtown, NY
National Provider Identifier
1952744534
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
487670-1 Issued in NY
Practice address
99 Hollywood Dr
Smithtown, NY 11787-3135
Phone
(631) 366-5800
Fax
(631) 366-5884
NPI assigned
Apr 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 487670-1 NY Primary

Addresses

Primary practice location

99 Hollywood Dr
Smithtown, NY 11787-3135

Mailing address

99A Lake Promenade
Lake Ronkonkoma, NY 11779-5335
Phone (631) 585-1303

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
487670-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1952744534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99A LAKE PROMENADE",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117795335",
            "telephone_number": "631-585-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 HOLLYWOOD DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873135",
            "telephone_number": "631-366-5800",
            "fax_number": "631-366-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILILLO",
        "first_name": "DENISE",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "487670-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.