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General NPI Number Information
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NPI Number | 1336707892
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Entity Type | Individual
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Provider Name | GERARD PELLEGRINI D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 160 E ERIE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1011
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Country | US
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Telephone | 215-427-4067
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Fax |
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Provider Business Mailing Address
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Address Line | 990 CORPORATE DRIVE APARTMENT 514
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City | WESTBURY
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State | NY
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Zip | 11590
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | OS025130
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 319163-01
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License Number State | NY
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