Individual
MICHAEL PECCERILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD,CDN
Contact information
Practice address
242 SWINNERTON ST, STATEN ISLAND, NY 10307-1641
(718) 317-8155
Mailing address
242 SWINNERTON ST, STATEN ISLAND, NY 10307-1641
(718) 317-8155
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
001265
NY
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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