Provider Demographics
NPI:1144791948
Name:INCOLLINGO, STEFANIA (DC)
Entity Type:Individual
Prefix:
First Name:STEFANIA
Middle Name:
Last Name:INCOLLINGO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 HUNTINGDON PIKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006
Mailing Address - Country:US
Mailing Address - Phone:215-990-4063
Mailing Address - Fax:
Practice Address - Street 1:3331 STREET ROAD
Practice Address - Street 2:TWO GREENWOOD SQUARE/STE 107
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2022
Practice Address - Country:US
Practice Address - Phone:267-522-8131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor