Provider Demographics
NPI:1851540876
Name:PREGO, JAMES (ND)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:PREGO
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3540
Mailing Address - Country:US
Mailing Address - Phone:631-650-0268
Mailing Address - Fax:631-930-3963
Practice Address - Street 1:560 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3540
Practice Address - Country:US
Practice Address - Phone:631-650-0268
Practice Address - Fax:631-930-3963
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1385175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath