Christopher Petillo
Student in an Organized Health Care Education/Training Program in Mineola, NY. Individual provider (NPI-1).
NPI number1003660044
StatusActive
Last updated in NPPESApr 16, 2024
Details
- NPI
- 1003660044
- Entity type
- Individual (NPI-1)
- Name
- Christopher Petillo
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 16, 2024
- Certification date
- Apr 16, 2024
- Last updated
- Apr 16, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
259 1st StMineola, NY 11501-3957
Phone 516-663-0333
Mailing address
259 1st StMineola, NY 11501-3957
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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