1659693042 NPI number — MR. PETER ANGELO PERFITO PHARMACIST

Table of content: MR. PETER ANGELO PERFITO PHARMACIST (NPI 1659693042)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659693042 NPI number — MR. PETER ANGELO PERFITO PHARMACIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PERFITO
Provider First Name:
PETER
Provider Middle Name:
ANGELO
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMACIST
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PERFITO
Provider Other First Name:
PETER
Provider Other Middle Name:
ANGELO
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMACIST
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1659693042
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 N HAMPTON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10603-1908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-980-5363
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 N HAMPTON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10603-1908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-980-5363
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/25/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  048553-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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