Individual
DR. DANIEL J PEZZULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, ABSNP, LCSW
Contact information
Practice address
154 ESTHER DR, LANCASTER, PA 17601-2047
(717) 413-2731
(717) 413-2731
Mailing address
154 ESTHER DR, LANCASTER, PA 17601-2047
(717) 413-2731
(717) 413-2731
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
04043671
PA
1041C0700X
Clinical Social Worker
Primary
CW012774
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
627225
BLUE SHIELD
PA
Enumeration date
12/06/2005
Last updated
09/08/2023
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