Healthcare Provider Details

I. General information

NPI: 1861092066
Provider Name (Legal Business Name): LOUIS WILLIAM PINGOTTI JR. DNP, FNP-C, WHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 477 BOX 2
FPO AP
96306-0001
US

IV. Provider business mailing address

PSC 477 BOX 2
FPO AP
96306-0001
US

V. Phone/Fax

Practice location:
  • Phone: 315-264-3207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number711354-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-4107
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN-4107
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-110794-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: