Provider Demographics
NPI:1093608085
Name:PELLO, DANIELLE (NP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:PELLO
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 1:1720 AUGUST RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1925
Mailing Address - Country:US
Mailing Address - Phone:934-777-6242
Mailing Address - Fax:
Practice Address - Street 1:10 OLD RIVERHEAD RD UNIT A
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-1460
Practice Address - Country:US
Practice Address - Phone:631-369-4292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY645121163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty