Provider Demographics
NPI:1770603169
Name:MUSCARELLA CHIROPRACTIC, PC
Entity type:Organization
Organization Name:MUSCARELLA CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUSCARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-342-7778
Mailing Address - Street 1:490 N KERRWOOD DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-5202
Mailing Address - Country:US
Mailing Address - Phone:724-342-7778
Mailing Address - Fax:724-342-7373
Practice Address - Street 1:490 N KERRWOOD DR
Practice Address - Street 2:SUITE 204
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-5202
Practice Address - Country:US
Practice Address - Phone:724-342-7778
Practice Address - Fax:724-342-7373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007082L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001356384OtherHIGHMARK BC BS PROVIDER
PAU73308Medicare UPIN
PA022628Medicare ID - Type Unspecified