Individual
ANTHONY A. PELOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9 4TH AVE, BAY SHORE, NY 11706-7908
(631) 665-6707
(631) 665-3564
Mailing address
22 KNOX AVE, STONY BROOK, NY 11790-1538
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
104072-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104072-1
LICENSURE
NY
Enumeration date
05/31/2011
Last updated
05/31/2011
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