Provider Demographics
NPI:1174537088
Name:PELLECCHIA, JOSEPH AP (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:AP
Last Name:PELLECCHIA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:310 WOODLOMOND WAY
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-3254
Mailing Address - Country:US
Mailing Address - Phone:304-733-3958
Mailing Address - Fax:
Practice Address - Street 1:1540 SPRING VALLEY DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25704-9300
Practice Address - Country:US
Practice Address - Phone:304-429-6741
Practice Address - Fax:304-429-6713
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA2700R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVB65336Medicare UPIN