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Individual

ANNETTE PERGAMO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.N.P.

Contact information

Practice address
101 NICOLLS RD # T11-020, STONY BROOK, NY 11794-1108
(631) 444-4601
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-4601

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
671930
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382510
NY

Other

Enumeration date
07/07/2014
Last updated
07/21/2022
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