Organization
SUBURBAN ORTHOPAEDICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PETOLILLO JR. DO (OWNER)
(215) 750-6700
Entity
Organization
Contact information
Practice address
240 MIDDLETOWN BLVD, SUITE 101D, LANGHORNE, PA 19047-1832
(215) 750-6700
(215) 750-6706
Mailing address
240 MIDDLETOWN BLVD, SUITE 101D, LANGHORNE, PA 19047-1832
(215) 750-6700
(215) 750-6706
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200044351
TRAVELERS MEDICARE
PA
01
—
989692
HIGHMARK BS
—
Enumeration date
01/26/2006
Last updated
04/12/2011
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