Individual
DR. RALPH J PETRUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
125 MEDICAL CAMPUS DR, SUITE 206, LANSDALE, PA 19446-7205
(215) 233-5688
Mailing address
125 MEDICAL CAMPUS DR, SUITE 206, LANSDALE, PA 19446-7205
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS0003012-L
PA
103T00000X
Psychologist
PS0003012-L
PA
Other
Enumeration date
02/27/2006
Last updated
05/25/2016
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