Individual
JASON PETRILLA
Active
Individual
JASON PETRILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
212534
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212534
TUFTS HEALTH PLAN
MA
01
—
J26361
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/18/2006
Last updated
07/08/2007
Update your record
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