Provider Demographics
NPI:1255435269
Name:PITONE, RANDALL EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:EUGENE
Last Name:PITONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 CARMEL ROAD
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332
Mailing Address - Country:US
Mailing Address - Phone:856-825-6810
Mailing Address - Fax:856-765-0252
Practice Address - Street 1:2038 CARMEL ROAD
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332
Practice Address - Country:US
Practice Address - Phone:856-825-6810
Practice Address - Fax:856-765-0252
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010587682084P0800X
TN310332084P0800X
NJ25MA079634002084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010057299Medicaid
4088360OtherMAGELLAN NAVIGATOR
VA010154618Medicaid
260050527OtherRAILROAD MEDICARE
4088360OtherMAGELLAN SUMMIT
620582605028OtherTRICARE NORTH
VA010057345Medicaid
620582605OtherBEECH STREET
334969OtherVALUE OPTIONS
TN3894689Medicaid
4088360OtherMAGELLAN PINNACLE
620582605OtherTHREE RIVERS
VA010149673Medicaid
351654200OtherDOL WORKERS COMP
260050527OtherRAILROAD MEDICARE
620582605OtherBEECH STREET
TN3894689Medicaid