Provider Demographics
NPI:1063667798
Name:PELLETIER, DONNA IALEGGIO (DVM)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:IALEGGIO
Last Name:PELLETIER
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:DR
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:IALEGGIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DVM
Mailing Address - Street 1:3400 W GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-1139
Mailing Address - Country:US
Mailing Address - Phone:215-243-5304
Mailing Address - Fax:215-243-0219
Practice Address - Street 1:3400 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-1139
Practice Address - Country:US
Practice Address - Phone:215-243-5304
Practice Address - Fax:215-243-0219
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABV006016L174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian