Provider Demographics
NPI:1386600096
Name:PETTINATO, JOSEPH B (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:PETTINATO
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 1:5420 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9652
Mailing Address - Country:US
Mailing Address - Phone:724-444-6644
Mailing Address - Fax:724-444-6671
Practice Address - Street 1:5420 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9652
Practice Address - Country:US
Practice Address - Phone:724-444-6644
Practice Address - Fax:724-444-6671
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-0006233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA790678OtherHIGHMARK BC/BS
PA311810OtherUPMC HEALTH PLAN
PA001614086Medicaid
PA232922858OtherCIGNA
PA790678Medicare ID - Type Unspecified
PA232922858OtherCIGNA