Individual
LAURA ANNE PELLEGRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
119 NEW YORK AVE, MASSAPEQUA, NY 11758-4601
(516) 799-2555
Mailing address
1180 CASSEL AVE, BAY SHORE, NY 11706-6116
(516) 236-1449
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308856
NY
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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