Provider Demographics
NPI:1548251952
Name:PIRRAGLIA, PETER DOMINIC (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:DOMINIC
Last Name:PIRRAGLIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 CADMAN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-6711
Mailing Address - Country:US
Mailing Address - Phone:631-671-5190
Mailing Address - Fax:
Practice Address - Street 1:256 CADMAN AVE
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6711
Practice Address - Country:US
Practice Address - Phone:631-671-5190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4673208000000X
NY170483208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics