Individual
MARY JANE PETRUZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
179829
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010137401
UNIVERA
—
01
—
000524343001
BC/BS
—
01
—
0015503720001
PA MEDICAID
—
05
—
01169979
—
NY
01
—
040426001061
FIDELIS
—
01
—
1206399
IHA
—
Enumeration date
10/21/2006
Last updated
09/30/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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