Individual
EDWARD PETRARCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1 BAY AVE, MOUNTAINSIDE HOSPITAL, MONTCLAIR, NJ 07042-4837
(973) 429-6813
(973) 680-7715
Mailing address
1 BAY AVE, MOUNTAINSIDE HOSPITAL, MONTCLAIR, NJ 07042-4837
(973) 429-6000
(973) 680-7715
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC00016500
NJ
Other
Enumeration date
11/09/2006
Last updated
07/10/2007
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