Provider Demographics
NPI:1427488816
Name:PELLITTERI, KARA
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:PELLITTERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 TONI ANN CIR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-6443
Mailing Address - Country:US
Mailing Address - Phone:516-383-5443
Mailing Address - Fax:516-933-3768
Practice Address - Street 1:6 TONI ANN CIR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-6443
Practice Address - Country:US
Practice Address - Phone:516-383-5443
Practice Address - Fax:516-933-3768
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0381212251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics