Provider Demographics
NPI:1972336105
Name:PANDOLFI, ALECIA D
Entity type:Individual
Prefix:
First Name:ALECIA
Middle Name:D
Last Name:PANDOLFI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S GEORGE ST # E-1
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4594
Mailing Address - Country:US
Mailing Address - Phone:717-741-4848
Mailing Address - Fax:717-650-6383
Practice Address - Street 1:2200 S GEORGE ST # 1
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4594
Practice Address - Country:US
Practice Address - Phone:717-741-4848
Practice Address - Fax:717-650-6383
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG08528172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist