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Individual

ERCOLE JOHN PETRUNGARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
333 1ST ST STE A, SAN FRANCISCO, CA 94105-2661
(888) 803-3370
Mailing address
10 LAFAYETTE ST, STATEN ISLAND, NY 10307-1225
(917) 921-7226

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010815
NY
363A00000X
Physician Assistant
25MP00256900
NJ
363AM0700X
Medical Physician Assistant
010815
NY

Other

Enumeration date
01/02/2007
Last updated
04/23/2025
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