Individual
DR. RAFFAELE A PETROSINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
22 YALE AVE, WAKEFIELD, MA 01880-2309
(781) 245-1871
(781) 245-7963
Mailing address
22 YALE AVE, WAKEFIELD, MA 01880-2309
(781) 245-1871
(781) 245-7963
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3862
MA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0369349
—
MA
01
—
152-122
HARVARD PILGRIM
MA
01
—
32916
FALLON
MA
01
—
755438
TUFTS
MA
01
—
W16034
BC BS OF MA
MA
Enumeration date
07/10/2006
Last updated
01/11/2010
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