Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN.CNP.0030440 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN.CNP.0030440 | OH |
N | 363LP2300X | Nurse Practitioner - Primary Care | APRN.CNP.0030440 | OH |
NPI | 1063171163 |
---|---|
Provider Name | Vincenzo Domenico Pilolli |
First Address | Cleveland, OH 44193-0026 |
Second Address | Hartville, OH 44632-7601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2021 |
Last Update Date | 16/12/2021 |