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General NPI Number Information
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NPI Number | 1699987321
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Entity Type | Organization
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Legal Business Name | PATRICK PELLECCHIA
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 1650 HUNTINGDON PIKE SUITE 350
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City | MEADOWBROOK
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State | PA
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Zip | 19046-8009
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Country | US
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Telephone | 215-947-9272
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Fax | 215-947-6487
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Provider Business Mailing Address
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Address Line | 1650 HUNTINGDON PIKE SUITE 350
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City | MEADOWBROOK
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State | PA
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Zip | 19046-8009
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Country | US
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Telephone | 215-947-9272
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Fax | 215-947-6487
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | PATRICK PELLECCHIA
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Credential | M.D.
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Telephone | 215-947-9272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD018379E
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License Number State | PA
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