Healthcare Provider Details

I. General information

NPI: 1760041677
Provider Name (Legal Business Name): JAMES RYAN PELLECHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 OLD LANCASTER RD STE 250
BRYN MAWR PA
19010-3239
US

IV. Provider business mailing address

24 HIGHVIEW RD
POUND RIDGE NY
10576-1310
US

V. Phone/Fax

Practice location:
  • Phone: 914-643-9377
  • Fax:
Mailing address:
  • Phone: 914-643-9377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT218386
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD495734
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMT218386
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: