Provider Demographics
NPI:1841349370
Name:FANELLI, DREW JAMES (DC)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:JAMES
Last Name:FANELLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CLIFFMINE RD STE 110
Mailing Address - Street 2:PARK WEST 2
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275-1008
Mailing Address - Country:US
Mailing Address - Phone:412-494-4550
Mailing Address - Fax:412-494-4551
Practice Address - Street 1:2000 CLIFFMINE RD STE 110
Practice Address - Street 2:PARK WEST 2
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1008
Practice Address - Country:US
Practice Address - Phone:412-494-4550
Practice Address - Fax:412-494-4551
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADCOO2269L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA414546OtherHIGHMARK
PA7997358OtherAETNA
PA9200143OtherCIGNA
PA414546OtherHIGHMARK
PA414546MBSMedicare PIN