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General NPI Number Information
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NPI Number | 1649044488
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Entity Type | Organization
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Legal Business Name | PELLEGRINO PLASTIC SURGERY LLC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 18947 JOHN J WILLIAMS HWY UNIT 215
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-4476
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Country | US
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Telephone | 302-643-2900
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Fax | 302-567-6799
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Provider Business Mailing Address
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Address Line | 18947 JOHN J WILLIAMS HWY UNIT 215
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-4476
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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 | OWNER
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Name | DR. CHRISTOPHER J PELLEGRINO
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Credential | MD
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Telephone | 302-643-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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