Provider Demographics
NPI:1861421836
Name:PIETRACCINI, JONPAUL JOSEPH (MED)
Entity type:Individual
Prefix:MR
First Name:JONPAUL
Middle Name:JOSEPH
Last Name:PIETRACCINI
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 W MONUMENT SQ
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-2188
Mailing Address - Country:US
Mailing Address - Phone:717-248-8197
Mailing Address - Fax:717-248-6449
Practice Address - Street 1:3 W MONUMENT SQ
Practice Address - Street 2:SUITE 206
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-2188
Practice Address - Country:US
Practice Address - Phone:717-248-8197
Practice Address - Fax:717-248-6449
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health