TINA M PETILLO DO NPI 1962437244

NPI Information

NPI: 1962437244
Provider Name: TINA M PETILLO, DO
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual
Address:
340 EAST NORTHFIELD ROAD
SUITE 2E
LIVINGSTON, NJ
ZIP 07039
Phone: (973) 533-0001
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Tina M Petillo, DO is an obstetrics gynecology in Livingston, NJ. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Tina M Petillo, DO NPI is 1962437244. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

340 EAST NORTHFIELD ROAD
SUITE 2E
LIVINGSTON, NJ
ZIP 07039-892
Phone: (973) 533-0001
Fax: (973) 716-0306

The enumeration date for this NPI number is 7/12/2006 and was last updated on 3/30/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207V00000X	Obstetrics & Gynecology		44503	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	699300	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY
2	F07536	MEDICARE UPIN
3	7413505	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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