Provider Demographics
NPI:1558359737
Name:PELLEGRINO, JANET LEE (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:PELLEGRINO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-2706
Mailing Address - Country:US
Mailing Address - Phone:978-685-4925
Mailing Address - Fax:978-682-3637
Practice Address - Street 1:170 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-2706
Practice Address - Country:US
Practice Address - Phone:978-685-4925
Practice Address - Fax:978-682-3637
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155686363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP2739OtherBCBS
MANP2739OtherBCBS