Individual
DR. LOUIS J. PETRACCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
332 BLOOMFIELD AVE, BLOOMFIELD, NJ 07003-4806
(973) 429-9225
(973) 566-0973
Mailing address
332 BLOOMFIELD AVE, BLOOMFIELD, NJ 07003-4806
(973) 429-9225
(973) 566-0973
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MA04021600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002507
—
NJ
01
—
48464
AETNA
NJ
01
—
P635038
OXFORD HEALTH PLANS
NJ
Enumeration date
03/07/2007
Last updated
07/08/2007
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