Provider Demographics
NPI:1629010525
Name:PETTINEO, STEVEN JAMES (MPT, DPT, CSCS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JAMES
Last Name:PETTINEO
Suffix:
Gender:M
Credentials:MPT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LEA DR
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-8983
Mailing Address - Country:US
Mailing Address - Phone:610-420-4249
Mailing Address - Fax:
Practice Address - Street 1:12 LEA DR
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-8983
Practice Address - Country:US
Practice Address - Phone:610-420-4249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012797L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2060042OtherHIGHMARK BLUE SHIELD
PA2276127OtherUNITED HEALTH CARE
PA877240OtherHEALTH AMERICA HEALTH ASSURANCE / COVENTRY
PA102167301-0001Medicaid
PA1629010525OtherBRAVO
PA40384PT012797LOtherHEALTH PARTNERS
PA2276127OtherUNITED HEALTH CARE
PA877240OtherHEALTH AMERICA HEALTH ASSURANCE / COVENTRY
PA2060042OtherHIGHMARK BLUE SHIELD
PA23-1365971OtherHUMANA
PA877240OtherHEALTH AMERICA HEALTH ASSURANCE / COVENTRY
PA23-1365971OtherDEVON
PA0493969000OtherKEYSTONE DIRECT POS
PA0493969000OtherPERSONAL CHOICE PPO