Provider Demographics
NPI:1568491611
Name:ANGELINI, GIANCARLO (DC)
Entity Type:Individual
Prefix:DR
First Name:GIANCARLO
Middle Name:
Last Name:ANGELINI
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 1:4500 FORT LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:MERCERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17236-9636
Mailing Address - Country:US
Mailing Address - Phone:717-328-2516
Mailing Address - Fax:
Practice Address - Street 1:4500 FORT LOUDON RD
Practice Address - Street 2:
Practice Address - City:MERCERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17236-9636
Practice Address - Country:US
Practice Address - Phone:717-328-2516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-002604-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30486Medicare UPIN