Provider Demographics
NPI:1629257886
Name:PARILLO, JILLANNE JANE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JILLANNE
Middle Name:JANE
Last Name:PARILLO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 HOWARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:CANDOR
Mailing Address - State:NY
Mailing Address - Zip Code:13743-2124
Mailing Address - Country:US
Mailing Address - Phone:607-659-4698
Mailing Address - Fax:
Practice Address - Street 1:76 HOWARD HILL RD
Practice Address - Street 2:
Practice Address - City:CANDOR
Practice Address - State:NY
Practice Address - Zip Code:13743-2124
Practice Address - Country:US
Practice Address - Phone:607-659-4698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286873164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02910176Medicaid