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Individual

DR. STEPHEN JAMES PETRUCCELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
39 DIVISION STREET, SAG HARBOR, NY 11963
(631) 725-8209
(631) 919-1592
Mailing address
PO BOX 2902, SAG HARBOR, NY 11963-0401
(631) 725-8209
(631) 725-8209

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
X010203
NY

Other

Enumeration date
12/05/2006
Last updated
03/17/2011
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