Provider Demographics
NPI:1992890271
Name:PESSOLANO, JOANNA C (MD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:C
Last Name:PESSOLANO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:450 WEST 33 RD STREET
Mailing Address - Street 2:PBS 12 TH FLOOR
Mailing Address - City:NEWYORK
Mailing Address - State:NY
Mailing Address - Zip Code:10310
Mailing Address - Country:US
Mailing Address - Phone:718-356-4474
Mailing Address - Fax:718-356-4608
Practice Address - Street 1:1583 RICHMOND AVE
Practice Address - Street 2:OBSTETRICS AND GYNECOLOGY
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1530
Practice Address - Country:US
Practice Address - Phone:718-983-0204
Practice Address - Fax:718-494-7420
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-12-27
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Provider Licenses
StateLicense IDTaxonomies
NY168824207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A60246Medicare UPIN
W99711Medicare PIN
W51097Medicare UPIN
NY06E591Medicare PIN