Pennella, Raffaele
Pennella, Raffaele is an sole proprietor health care provider with primary practice located at 3808 S Greystone Ct , Springfield MO 65804. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Pennella, Raffaele can be contacted via phone (417) 889-3332.Contact Information
Primary practice address
3808 S Greystone Ct
Springfield MO 65804
Phone: (417) 889-3332
Fax: (417) 881-1410
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 110288 | Missouri |
Profile Details
| NPI number | 1558400788 |
|---|---|
| LBN Legal business name | Pennella, Raffaele |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 5th, 2007 |
| Last updated | Dec 8th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558400788 | NPPES |
| Arkansas | MEDICAID | 156123001 | |
| Arkansas | MEDICAID | 208269902 | |
| Arkansas | Other | 81292 | |
| Arkansas | Other | 31905 |
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