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General NPI Number Information
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NPI Number | 1164794889
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Entity Type | Individual
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Provider Name | DANIEL JOSEPH PICCILLO D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2012
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Last Update Date | 09/12/2015
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Provider Practice Location Address
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Address Line | 2401 E TIOGA ST
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City | PHILADELPHIA
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State | PA
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Zip | 19134-4625
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Country | US
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Telephone | 267-519-9547
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Fax | 267-519-9567
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Provider Business Mailing Address
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Address Line | 901 N PENN ST F904
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City | PHILADELPHIA
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State | PA
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Zip | 19123-3132
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Country | US
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Telephone | 570-417-1509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC010552
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License Number State | PA
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