Basic Information
| Provider Information | |||||||||
| NPI: | 1780743138 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JOHN D.PILLA MD PA | ||||||||
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| OtherOrganizationName: | CENTRAL JERSEY MEDICAL DIAGNOSTICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 845 | ||||||||
| Address2: | |||||||||
| City: | GREEN BROOK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088122619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329681217 | ||||||||
| FaxNumber: | 7329684898 | ||||||||
| Practice Location | |||||||||
| Address1: | 1005 N. WASHINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | GREEN BROOK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088122619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329681217 | ||||||||
| FaxNumber: | 7329684898 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2006 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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| AuthorizedOfficialLastName: | PILLA | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7329688900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207RC0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.