Provider Demographics
NPI:1265963201
Name:PILEGGI, SANDRA
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:PILEGGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:ALBRIGHTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18210-3302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:668 OLD STAGE RD
Practice Address - Street 2:
Practice Address - City:ALBRIGHTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18210-3302
Practice Address - Country:US
Practice Address - Phone:570-994-3662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN566702163WD0400X
NJ26NR18008600163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator