Individual
DR. CARLO J PELINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1200 W GODFREY AVE, PHILADELPHIA, PA 19141-3323
(215) 276-6000
(215) 276-1329
Mailing address
500 WEST AVE, APT B14, JENKINTOWN, PA 19046-2726
(215) 421-3241
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000913
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0459326000
KEYSTONE EAST
PA
01
—
05571
BLUE SHIELD
PA
Enumeration date
09/26/2006
Last updated
07/08/2007
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