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Individual

BOBBI ALFRED PELLEGRINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1099 TARGEE STREET, STATEN ISLAND, NY 10304-4310
(718) 448-3210
(718) 815-3379
Mailing address
1099 TARGEE STREET, ADMINISTRATION, STATEN ISLAND, NY 10304-4310
(718) 448-3210
(718) 720-1271

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
013458
NY
363AM0700X
Medical Physician Assistant
013458
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03226386
NY
Enumeration date
08/05/2009
Last updated
07/07/2010
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