Provider Demographics
NPI:1225018799
Name:TELLIN, WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:TELLIN
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 1:69 STANDISH BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1532
Mailing Address - Country:US
Mailing Address - Phone:412-992-6768
Mailing Address - Fax:
Practice Address - Street 1:1720 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1208
Practice Address - Country:US
Practice Address - Phone:412-833-6323
Practice Address - Fax:412-833-6439
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001555L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00617323Medicaid
PA00617323Medicaid
PA151593Medicare ID - Type Unspecified