Individual
ANTHONY MICHAEL PELLEGRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
271 CAREW ST, SPRINGFIELD, MA 01104-2377
(413) 748-9000
Mailing address
47 ALLEN RD DEPT OF, LONGMEADOW, MA 01106-1322
(508) 633-2466
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AP2303
MA
363AM0700X
Medical Physician Assistant
0661
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30336642
—
NH
01
—
P00730832
RAILROAD MEDICARE
NH
Enumeration date
01/25/2007
Last updated
11/14/2022
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