# TINA M. PETILLO DO PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811161557
- **Authorized official:** TINA M PETILLO D.O. (DOCTOR)
- **Authorized official phone:** (973) 533-0001

## Contact information

- **Practice address:** 340 E NORTHFIELD RD, SUITE 2E, LIVINGSTON, NJ 07039-4892
- **Practice address phone:** (973) 533-0001
- **Practice address fax:** (973) 716-0306
- **Mailing address:** 340 E NORTHFIELD RD, SUITE 2E, LIVINGSTON, NJ 07039-4892
- **Mailing address phone:** (973) 533-0001
- **Mailing address fax:** (973) 716-0306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 25MB04450300 | NJ | Yes |

## Other

- **Enumeration date:** 04/14/2008
- **Last updated:** 03/30/2011