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General NPI Number Information
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NPI Number | 1124387113
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Entity Type | Individual
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Provider Name | JOSEPH KING PISCITELLO MD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 1240 HUFFMAN MILL RD
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City | BURLINGTON
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State | NC
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Zip | 27215-8700
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Country | US
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Telephone | 336-585-1770
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Fax | 336-585-1771
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Provider Business Mailing Address
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Address Line | 3100 SPRING FOREST RD SUITE 130
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City | RALEIGH
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State | NC
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Zip | 27616-2880
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Country | US
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Telephone | 919-882-0795
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2016-00078
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License Number State | NC
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