Provider Demographics
NPI:1003283748
Name:PELLEGRINI, ANN (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:PELLEGRINI
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WASHINGTON SQUARE VLG APT 16E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1809
Mailing Address - Country:US
Mailing Address - Phone:917-445-0157
Mailing Address - Fax:
Practice Address - Street 1:3 WASHINGTON SQUARE VLG APT 16E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1809
Practice Address - Country:US
Practice Address - Phone:917-445-0157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY001110102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program