Organization
MICHAEL PETRUSKA OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL PETRUSKA O. D. (PRESIDENT)
(908) 454-2300
Entity
Organization
Contact information
Practice address
1326 BELVIDERE RD, PHILLIPSBURG, NJ 08865-2004
(908) 454-2300
(908) 454-1661
Mailing address
1326 BELVIDERE RD, PHILLIPSBURG, NJ 08865-2004
(908) 454-2300
(908) 454-1661
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00616700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0180025
—
NJ
Enumeration date
08/17/2008
Last updated
05/14/2009
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