Healthcare Provider Details

I. General information

NPI: 1972690618
Provider Name (Legal Business Name): PETER MICHAEL PILLITTERI M.D., FACEP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JORDAN HOSPITAL ER 275 SANDWICH STREET
PLYMOUTH MA
02360
US

IV. Provider business mailing address

221 COURT STEET
PLYMOUTH MA
02360
US

V. Phone/Fax

Practice location:
  • Phone: 508-830-2800
  • Fax: 508-830-2836
Mailing address:
  • Phone: 508-746-6162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number75647
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number75647
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: