Individual
BENJAMIN BERNARD PETICCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2580 HAYMAKER RD STE 201, MONROEVILLE, PA 15146-3500
(412) 856-7500
(412) 856-6079
Mailing address
2580 HAYMAKER RD STE 201, MONROEVILLE, PA 15146-3500
(412) 856-7500
(412) 856-6079
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD025238E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001022620
—
PA
Enumeration date
10/27/2005
Last updated
08/06/2021
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