Provider Demographics
NPI:1235309287
Name:PINELLI, DESMOND ALBERT (DC)
Entity Type:Individual
Prefix:
First Name:DESMOND
Middle Name:ALBERT
Last Name:PINELLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 N HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3229
Mailing Address - Country:US
Mailing Address - Phone:410-638-5333
Mailing Address - Fax:410-638-7440
Practice Address - Street 1:522 N HICKORY AVE
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3229
Practice Address - Country:US
Practice Address - Phone:410-638-5333
Practice Address - Fax:410-638-7440
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD132352YFXZMedicare PIN
MDU56127Medicare UPIN