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Organization
LOUIS D PETRELLIS DO LTD
Active
Organization
LOUIS D PETRELLIS DO LTD
Active
Other names
Red Lion Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS DANIEL PETRELLIS DO (PRESIDENT PHYSICIAN)
(215) 673-2522
Entity
Organization
Contact information
Practice address
723 RED LION RD, PHILADELPHIA, PA 19115
(215) 673-2522
(215) 677-1083
Mailing address
723 RED LION RD, PHILADELPHIA, PA 19115
(215) 673-2522
(215) 677-1083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0S006198L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01272990
—
PA
Enumeration date
07/04/2006
Last updated
08/22/2020
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