Provider Demographics
NPI:1306205463
Name:DELPIZZO, PIETRA
Entity Type:Individual
Prefix:
First Name:PIETRA
Middle Name:
Last Name:DELPIZZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BRYN MAWR AVE
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2608
Mailing Address - Country:US
Mailing Address - Phone:610-639-2063
Mailing Address - Fax:
Practice Address - Street 1:2050 W CHESTER PIKE
Practice Address - Street 2:SUITE # 115
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2744
Practice Address - Country:US
Practice Address - Phone:610-449-9669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA12190225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist