Individual
DR. LANNY C PELLICCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
270 PIERCE ST, STE 301, KINGSTON, PA 18704-5141
(570) 283-3668
(570) 283-0309
Mailing address
270 PIERCE ST, STE 301, KINGSTON, PA 18704-5141
(570) 283-3668
(570) 283-0309
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC-003688-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001285747/0002
—
PA
01
—
05152
EMPIRE BC/BS
—
01
—
0528845
AETNA / HMO
—
01
—
075903
FIRST PRIORITY HEALTH
PA
01
—
150228
GATEWAY
—
01
—
1502456
UNITED MINE WORKERS
—
01
—
232635090 001
TRICARE / CHAMPUS
—
01
—
26464
GEISINGER HEALTH PLAN
PA
01
—
4532974
AETNE / PPO
—
01
—
611664
TRIGON / MEDIGAP
—
01
—
76219
MEDPLUS
—
01
—
G09847
AMERIHEALTH
—
01
—
P3179662
OXFORD
—
01
—
PE709847
BLUE CROSS / BLUE SHIELD
PA
01
—
U27800
HEALTH ASSURANCE
—
Enumeration date
06/21/2005
Last updated
12/06/2007
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