Provider Demographics
NPI:1124380845
Name:VISCO-PELLICCIO, SANDRINA (SPED)
Entity Type:Individual
Prefix:MRS
First Name:SANDRINA
Middle Name:
Last Name:VISCO-PELLICCIO
Suffix:
Gender:F
Credentials:SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3619
Mailing Address - Country:US
Mailing Address - Phone:845-215-5846
Mailing Address - Fax:
Practice Address - Street 1:2 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-3619
Practice Address - Country:US
Practice Address - Phone:845-215-5846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist