Provider Demographics
NPI:1255692174
Name:PELLICCIONI, KRISTINA (MAED)
Entity Type:Individual
Prefix:MISS
First Name:KRISTINA
Middle Name:
Last Name:PELLICCIONI
Suffix:
Gender:F
Credentials:MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 84TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3501
Mailing Address - Country:US
Mailing Address - Phone:718-996-6464
Mailing Address - Fax:
Practice Address - Street 1:2441 84TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3501
Practice Address - Country:US
Practice Address - Phone:718-996-6464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist