Individual
LOUIS PELLEGRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 IRVING AVE, CROUSE POB, SYRACUSE, NY 13210-1603
(315) 464-6395
(315) 464-7564
Mailing address
725 IRVING AVE, CROUSE POB, SYRACUSE, NY 13210-1603
(315) 464-6395
(315) 464-7564
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
185838
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01404291
—
NY
Enumeration date
05/28/2006
Last updated
08/27/2013
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