Pellegrino, Joan Elizabeth

Pellegrino, Joan Elizabeth is an individual health care provider with primary practice located at 725 Irving Ave Crouse Pob, Syracuse NY 13210-1603. She recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), which is considered as her primary health care specialty. Pellegrino, Joan Elizabeth can be contacted via phone (315) 464-6395.

Contact Information

Primary practice address
725 Irving Ave Crouse Pob Syracuse NY 13210-1603
Phone: (315) 464-6395
Fax: (315) 464-7238
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) 207SG0201X 233547 New York

Profile Details

NPI number 1407876584
LBN Legal business name Pellegrino, Joan Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Aug 27th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407876584 NPPES
New York MEDICAID 02619152

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