Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MT190601 | PA |
NPI | 1003076183 |
---|---|
Provider Name | Rian John Pillitteri |
First Address | Philadelphia, PA 19146-1325 |
Second Address | Philadelphia, PA 19102-1121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 12/06/2008 |