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General NPI Number Information
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NPI Number | 1467324830
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Entity Type | Individual
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Provider Name | ANTONIO JOHN PELLEGRINI
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Gender | Male
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 525 NJ-35
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City | MIDDLETOWN TOWNSHIP
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State | NJ
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Zip | 07701
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Country | US
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Telephone | 848-216-0765
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Fax |
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Provider Business Mailing Address
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Address Line | 1374 PAUL BLVD
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-4133
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Country | US
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Telephone | 551-655-7716
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00342400
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License Number State | NJ
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