Provider Demographics
NPI:1790893121
Name:TELESCO, WILLIAM VITO (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:VITO
Last Name:TELESCO
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 1:380 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 706
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1845
Mailing Address - Country:US
Mailing Address - Phone:215-741-0700
Mailing Address - Fax:215-750-2661
Practice Address - Street 1:380 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 706
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1845
Practice Address - Country:US
Practice Address - Phone:215-741-0700
Practice Address - Fax:215-750-2661
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003310L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4692772OtherUNITED HEALTH CARE
PAMI1751025OtherHIGHMARK PA BLUE SHIELD
PA4523147OtherAETNA
PA1031455OtherKEYSTONE MERCY
PA2418390000OtherKEYSTONE
PA01077440-01OtherAMERICHOICE
PA2418390000OtherPERSONAL CHOICE
PA01077440-01OtherAMERICHOICE