Individual
EUGENE R. PELLERIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 NORTON AVE, ONEONTA, NY 13820
(607) 431-5305
(607) 431-5723
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(512) 852-5563
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
218574
NY
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
218574
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02543846
—
NY
Enumeration date
09/21/2006
Last updated
03/01/2019
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