Provider Demographics
NPI:1982660445
Name:LANCELLOTTI, GIUSEPPE (MD)
Entity Type:Individual
Prefix:DR
First Name:GIUSEPPE
Middle Name:
Last Name:LANCELLOTTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 NORTH READING RD
Mailing Address - Street 2:BACA PEDIATRICS
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1671
Mailing Address - Country:US
Mailing Address - Phone:717-733-0790
Mailing Address - Fax:717-733-1802
Practice Address - Street 1:159 NORTH READING RD
Practice Address - Street 2:BACA PEDIATRICS
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1671
Practice Address - Country:US
Practice Address - Phone:717-733-0790
Practice Address - Fax:717-733-1802
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036088E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232416802Medicaid
01686701OtherCAPITAL BLUE CROSS
PA0010499370002Medicaid