Provider Demographics
NPI:1982683025
Name:PINNELAS, DAVID J (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:PINNELAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1820 STATE ROUTE 33
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4860
Mailing Address - Country:US
Mailing Address - Phone:732-776-8500
Mailing Address - Fax:732-988-2347
Practice Address - Street 1:1820 STATE ROUTE 33
Practice Address - Street 2:SUITE 4B
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4860
Practice Address - Country:US
Practice Address - Phone:732-776-8500
Practice Address - Fax:732-988-2347
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05743000207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223247181OtherHORIZON BCBS
223247181OtherINTERGROUP
NJ588679OtherCIGNA
P00262891OtherRAILROAD MEDICARE
223247181OtherCHN
223247181OtherMULTIPLAN
223247181012OtherQUALCARE
431942OtherAETNA
NJ723059AXTMedicare ID - Type Unspecified
NJ223247181OtherHORIZON BCBS