Organization
JOSEPH AND ERICA PETITTI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH N PETITTI (OWNER)
(860) 658-1620
Entity
Organization
Contact information
Practice address
883 HOPMEADOW ST, SIMSBURY, CT 06070-1821
(860) 658-1620
(860) 658-7923
Mailing address
883 HOPMEADOW ST, SIMSBURY, CT 06070-1821
(860) 658-1620
(860) 658-7923
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CT1034
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C00774
MEDICARE GROUP NUMBER
CT
Enumeration date
04/04/2008
Last updated
05/09/2008
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