| Dr. Philip J. Pellegrino, Llc | |
|
623 W Union Blvd Ste 1c Bethlehem PA 18018-3708 | |
| (610) 936-8470 | |
| Not Available |
| Full Name | Dr. Philip J. Pellegrino, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 623 W Union Blvd Ste 1c, Bethlehem, Pennsylvania |
| Authorized Official Name and Position | Philip J Pellegrino (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6109368470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Philip J. Pellegrino, Llc 121 Ashview Ct Nazareth PA 18064-8688 Ph: (215) 715-0820 | Dr. Philip J. Pellegrino, Llc 623 W Union Blvd Ste 1c Bethlehem PA 18018-3708 Ph: (610) 936-8470 |
| NPI Number | 1235737917 |
|---|---|
| Provider Enumeration Date | 10/14/2020 |
| Last Update Date | 12/29/2023 |
| Certification Date | 12/29/2023 |
| Medicare PECOS PAC ID | 0446661235 |
|---|---|
| Medicare Enrollment ID | O20201130002595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235737917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Philip J Pellegrino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326204868 PECOS PAC ID: 9234316621 Enrollment ID: I20110613000353 |
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