Provider Demographics
NPI:1114919198
Name:JOHN J PARILLO MD PC
Entity Type:Organization
Organization Name:JOHN J PARILLO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-370-5858
Mailing Address - Street 1:PO BOX 9152
Mailing Address - Street 2:J PARILLO MD
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-0152
Mailing Address - Country:US
Mailing Address - Phone:518-370-5858
Mailing Address - Fax:
Practice Address - Street 1:1055 NOTT ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2432
Practice Address - Country:US
Practice Address - Phone:518-370-5858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDH1066Medicare PIN
BA0350Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER