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Individual
NICOLE MARIE PELLEGRINI
Active
Individual
NICOLE MARIE PELLEGRINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011549
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000414310001
BSNENY
NY
05
—
02939155
—
NY
01
—
071219000066
FIDELIS
NY
01
—
10128386
CDPHP
NY
01
—
396781
MVP
NY
Enumeration date
10/24/2006
Last updated
01/26/2018
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