Provider Demographics
NPI:1487489175
Name:PELLEGRINO, SARAH (NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PELLEGRINO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 GLENSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4325
Mailing Address - Country:US
Mailing Address - Phone:302-577-0390
Mailing Address - Fax:
Practice Address - Street 1:220 CONTINENTAL DR STE 407
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4315
Practice Address - Country:US
Practice Address - Phone:302-657-1724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0012888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily