Individual
MARY KATHERINE PERRELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
21 WILLOW POND WAY, STE 200, PENFIELD, NY 14526-2687
(585) 377-0840
(585) 377-9715
Mailing address
21 WILLOW POND WAY, STE 200, PENFIELD, NY 14526-2687
(585) 377-0840
(585) 377-9715
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
F380707-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019179DL
PREFERRED CARE
NY
Enumeration date
07/13/2006
Last updated
07/08/2007
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