Provider Demographics
NPI:1780408534
Name:PILEGGI, JUSTINE (LAC)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:PILEGGI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 ASHBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2680
Mailing Address - Country:US
Mailing Address - Phone:215-692-7334
Mailing Address - Fax:
Practice Address - Street 1:716 N BETHLEHEM PIKE STE 204A
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2656
Practice Address - Country:US
Practice Address - Phone:215-692-7334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001206171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty