| Stacy Pellettieri | |
|
400 Jericho Tpke Ste 104 Jericho NY 11753-1320 | |
| (516) 680-5967 | |
| Not Available |
| Full Name | Stacy Pellettieri |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 400 Jericho Tpke Ste 104, Jericho, New York |
| Authorized Official Name and Position | Stacy Leigh Pellettieri (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 5166805967 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacy Pellettieri 149 Country Club Dr Commack NY 11725-4458 Ph: (516) 680-5967 | Stacy Pellettieri 400 Jericho Tpke Ste 104 Jericho NY 11753-1320 Ph: (516) 680-5967 |
| NPI Number | 1689331035 |
|---|---|
| Provider Enumeration Date | 11/19/2021 |
| Last Update Date | 11/19/2021 |
| Certification Date | 11/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689331035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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