Provider Demographics
NPI:1184862195
Name:PILLITTERI, EILEEN MARIE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MARIE
Last Name:PILLITTERI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:160 OAK NECK LN
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-5144
Mailing Address - Country:US
Mailing Address - Phone:631-242-7444
Mailing Address - Fax:631-242-3810
Practice Address - Street 1:2017 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-2727
Practice Address - Country:US
Practice Address - Phone:631-242-7444
Practice Address - Fax:631-242-3810
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY006293363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11-3251969OtherMARK PILLITTERI, DO