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General NPI Number Information
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NPI Number | 1891787792
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Entity Type | Individual
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Provider Name | BARRIE JOSEPH PILGRIM DC, PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 6 EUCLID AVE BLDG 2
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City | CORTLAND
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State | NY
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Zip | 13045-1257
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Country | US
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Telephone | 607-753-9076
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Fax | 607-753-7506
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Provider Business Mailing Address
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Address Line | 100 METROPOLITAN PARK DR STE 100
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City | LIVERPOOL
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State | NY
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Zip | 13088-5842
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Country | US
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Telephone | 315-870-9370
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Fax | 315-558-6611
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH030070
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110-005907
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 021318-1
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License Number State | NY
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