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Individual

JACK P PARILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
35 GILBERT ST, CAMBRIDGE FAMILY HEALTH CENTER, CAMBRIDGE, NY 12816-2618
(518) 677-3961
(518) 677-3180
Mailing address
PO BOX 304, GLENS FALLS, NY 12801-0304
(518) 677-3961
(518) 677-3180

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
145074
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
145074-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000462005001
SENIOR BLUE
NY
05
00650266
NY
01
10017565
CDPHP
NY
01
145074A
PREFERRED CARE
NY
01
68E431
BLUE CROSS
NY
01
91032
MVP
NY
Enumeration date
05/21/2007
Last updated
06/05/2012
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