| Sue Pellerito Llc | |
|
2311 Shelby Ave Ste 105a Ann Arbor MI 48103-3849 | |
| (734) 775-0662 | |
| (734) 726-5138 |
| Full Name | Sue Pellerito Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2311 Shelby Ave Ste 105a, Ann Arbor, Michigan |
| Authorized Official Name and Position | Suzanne M Pellerito (OWNER) |
| Authorized Official Contact | 7347750662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sue Pellerito Llc 9915 Huron River Dr Dexter MI 48130-9466 Ph: (734) 775-0662 | Sue Pellerito Llc 2311 Shelby Ave Ste 105a Ann Arbor MI 48103-3849 Ph: (734) 775-0662 |
| NPI Number | 1164042917 |
|---|---|
| Provider Enumeration Date | 04/22/2020 |
| Last Update Date | 04/22/2020 |
| Certification Date | 04/22/2020 |
| Medicare PECOS PAC ID | 8729418975 |
|---|---|
| Medicare Enrollment ID | O20200430002360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164042917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Suzanne M Pellerito |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548431737 PECOS PAC ID: 2860650355 Enrollment ID: I20120301000444 |
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