Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 15988 | NH |
N | 207XS0106X | Orthopaedic Hand Surgeon | 15988 | NH |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 15988 | NH |
NPI | 1487607529 |
---|---|
Provider Name | Dr. Vincent D. Pellegrini JR. |
First Address | Lebanon, NH 03756-0001 |
Second Address | Lebanon, NH 03756-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 03/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1021348 | (05) | VT |
202181101 | (05) | MD |
3116918 | (05) | NH |
A52919 | (02) |