Organization
ROBERT K. PETRELLI, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT K PETRELLI SR. D.O. (OWNER)
(609) 522-4199
Entity
Organization
Contact information
Practice address
1400 NEW JERSEY AVE, NORTH WILDWOOD, NJ 08260-2738
(609) 522-4199
(609) 522-3692
Mailing address
1400 NEW JERSEY AVE, NORTH WILDWOOD, NJ 08260-2738
(609) 522-4199
(609) 522-3692
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
NJ3013
NJ
332BC3200X
Customized Equipment (DME)
PA-OE004707L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0097739000
AMERIHEALTH
NJ
05
—
2400901
—
NJ
01
—
455040
AETNA
NJ
Enumeration date
11/30/2007
Last updated
12/04/2007
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