Provider Demographics
NPI:1972690618
Name:PILLITTERI, PETER MICHAEL (MD, FACEP)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:MICHAEL
Last Name:PILLITTERI
Suffix:
Gender:M
Credentials:MD, FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 COURT STEET
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-746-6162
Mailing Address - Fax:
Practice Address - Street 1:JORDAN HOSPITAL ER
Practice Address - Street 2:275 SANDWICH STREET
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:508-830-2800
Practice Address - Fax:508-830-2836
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75647146D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3105661Medicaid
MAJ13363OtherBCBS
MAA28922Medicare PIN
MAF48532Medicare UPIN
MATX5263Medicare PIN