Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC-003589L | PA |
NPI | 1366640435 |
---|---|
Provider Name | Dr. Joseph A Perelli |
First Address | Whitehall, PA 18052-5836 |
Second Address | Whitehall, PA 18052-5836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 10/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116116 | (02) | PA |