Basic Information
| Provider Information | |||||||||
| NPI: | 1972570570 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PILEGGI | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | M.S.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 306 SWEDESFORD RD | ||||||||
| Address2: | |||||||||
| City: | NORTH WALES | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194542480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156612870 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2400 MARYLAND RD | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | WILLOW GROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190901700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156571115 | ||||||||
| FaxNumber: | 2156571848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT006937L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 2256478000 | 01 | PA | IBC | OTHER | 11443251 | 01 | PA | CAQH | OTHER | 3756553 | 01 | PA | AETNA | OTHER |