Individual
EDWARD PELLICANO
Active
Individual
EDWARD PELLICANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
037330
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037330
LICENSE
GA
Enumeration date
04/25/2006
Last updated
03/28/2008
Update your record
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