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Individual

MR. STEVEN ALAN PETRARCA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OST CPED

Contact information

Practice address
135 FRENCHTOWN ROAD, SUITE 4, NORTH KINGSTOWN, RI 02852-1783
(401) 885-5004
(401) 885-8283
Mailing address
135 FRENCHTOWN ROAD, SUITE 4, NORTH KINGSTOWN, RI 02852-1783
(401) 885-5004
(401) 885-8283

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29672
BLUE CROSS
01
408288
BLUE CHIP
Enumeration date
05/24/2007
Last updated
07/08/2007
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