Provider Demographics
NPI:1851356505
Name:PARRILLA, TODD M (DO)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:M
Last Name:PARRILLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 PELLEGRINO RD
Mailing Address - Street 2:
Mailing Address - City:STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06378-2128
Mailing Address - Country:US
Mailing Address - Phone:860-535-3421
Mailing Address - Fax:860-599-3575
Practice Address - Street 1:20 S ANGUILLA RD
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-1447
Practice Address - Country:US
Practice Address - Phone:860-599-3839
Practice Address - Fax:860-599-3575
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTOOO415208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001004150Medicaid