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NPI Code Detail

MEDICARE: DR. LORI PELLEGRINO M.D.

MEDICARE:  DR. LORI  PELLEGRINO  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician228021NY

General Provider Information

NPI Number : 1033265525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORI PELLEGRINO M.D.
Provider Business Mailing Address
First Line : 320 CENTRAL PARK W
Second Line : SUITE 1E
City : NEW YORK
State : NY
Zip : 10025-7659
Country : US
Telephone Number : 212-874-7448
Fax Number :
Provider Business Practice Location Address
First Line : 320 CENTRAL PARK W
Second Line : SUITE 1E
City : NEW YORK
State : NY
Zip : 10025-7659
Country : US
Telephone Number : 212-874-7448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 07/08/2007

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Directions to “ DR. LORI PELLEGRINO M.D.” Practice Location

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