Individual
DR. EDWARD J PETRELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 CARNIE BLVD, SUITE B-5, VOORHEES, NJ 08043-4512
(856) 751-0123
(856) 751-0535
Mailing address
SOUTH JERSEY RADIOLOGY ASSOCIATES, PA, PO BOX 23355, NEWARK, NJ 07189-0001
(856) 770-0300
(856) 770-0395
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA02335200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0069675000
AMERIHEALTH
—
01
—
0804225
AETNA
—
01
—
1089884
HORIZON NJ HEALTH
—
05
—
1161407
—
NJ
01
—
1243590
UNITED HEALTHCARE
—
01
—
300047117
RAILROAD MEDICARE
—
01
—
A3738029
OXFORD HEALTH
—
01
—
PE000869
PREMIER BLUE
—
Enumeration date
07/19/2005
Last updated
11/27/2007
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