Individual
FABIO PETROCCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 HARRISON AVE, MOAKLEY, 3RD FLOOR, BOSTON, MA 02118
(617) 638-6428
(617) 638-5756
Mailing address
801 ALBANY ST, FL G, BOSTON, MA 02119
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
286320
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110169294A
—
MA
05
—
3129358
—
NH
Enumeration date
09/08/2020
Last updated
02/17/2022
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