Provider Demographics
NPI:1982967436
Name:PELLEGRINO, LUISA CRISTINA (MS)
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:CRISTINA
Last Name:PELLEGRINO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 BOWMAN DR
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-3238
Mailing Address - Country:US
Mailing Address - Phone:203-531-7875
Mailing Address - Fax:
Practice Address - Street 1:73 BOWMAN DR
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-3238
Practice Address - Country:US
Practice Address - Phone:203-531-7875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist