Individual
RANDI A PETRICONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
850 HARRISON AVE, YACC 4, BOSTON, MA 02118-4001
(617) 414-2000
(617) 414-5798
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN263379
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110076888A
—
MA
Enumeration date
07/18/2007
Last updated
08/07/2014
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