Michael Peccerillo, RD,CDN
Nutritionist in Staten Island, NY. Individual provider (NPI-1).
NPI number1609089341
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1609089341
- Entity type
- Individual (NPI-1)
- Name
- Michael Peccerillo
- Credential
- RD,CDN
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 8, 2007
- Last updated
- Jul 8, 2007
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 |
|---|---|---|---|---|
| 133N00000X | Nutritionist | 001265 | NY | Yes |
Practice location
242 Swinnerton StStaten Island, NY 10307-1641
Phone 718-317-8155
Mailing address
242 Swinnerton StStaten Island, NY 10307-1641
Phone 718-317-8155
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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All 10 Nutritionist providers in Staten Island · All 15,106 providers in Staten Island
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