Organization
CLARKSTOWN PULMONARY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN THOMAS PELLICONE MD (PHYSICIAN OWNER)
(845) 786-4060
Entity
Organization
Contact information
Practice address
51-55 ROUTE 9W, WEST HAVERSTRAW, NY 10993-1912
(845) 786-4060
(845) 786-4066
Mailing address
51-55 ROUTE 9W, WEST HAVERSTRAW, NY 10993-1912
(845) 786-4060
(845) 786-4066
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01243741
—
NY
Enumeration date
01/18/2007
Last updated
01/11/2010
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