Pellegrino, Louis

Pellegrino, Louis is an individual health care provider with primary practice located at 725 Irving Ave Crouse Pob, Syracuse NY 13210-1603. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities, which is considered as his primary health care specialty. Pellegrino, Louis 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) 464-7564
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X 185838 New York

Profile Details

NPI number 1619924354
LBN Legal business name Pellegrino, Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2006
Last updated Aug 27th, 2013 - about 11 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 1619924354 NPPES
New York MEDICAID 01404291

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