Provider Demographics
NPI:1477030484
Name:PELLEGRINO, ALBERTA (MHC)
Entity Type:Individual
Prefix:
First Name:ALBERTA
Middle Name:
Last Name:PELLEGRINO
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 BLOOMINGDALE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2009
Mailing Address - Country:US
Mailing Address - Phone:718-496-2705
Mailing Address - Fax:
Practice Address - Street 1:570 BLOOMINGDALE RD FL 2
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2009
Practice Address - Country:US
Practice Address - Phone:718-496-2705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health