Individual
MR. ANTONIO PEDULLA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
14 ROGERS RD STE 211, NORTH EAST, MD 21901-3612
(410) 280-7683
(610) 702-8056
Mailing address
2207 CONCORD PIKE # 197, WILMINGTON, DE 19803-2908
(610) 998-3902
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN674446
PA
363LF0000X
Family Nurse Practitioner
SP024827
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP027026
PA
Other
Enumeration date
11/04/2021
Last updated
02/13/2025
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