Individual
MR. CHARLES NICHOLAS PIRRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
5821 ROUTE 80, TULLY, NY 13159
(315) 696-6114
(315) 696-8509
Mailing address
5821 ROUTE 80, TULLY, NY 13159
(315) 696-6114
(315) 696-8509
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F333524
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02289581
—
NY
01
—
385865
ANCC BOARD CERTIFICATION
—
01
—
516186
REGISTERED PROFESSIONAL NURSE LICENSE
NY
01
—
F333524
FAMILY NURSE PRACTITIONER LICENSE
NY
Enumeration date
06/16/2008
Last updated
03/07/2023
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