Individual
DR. ROBERT CORTESE PETRUCELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PA
Contact information
Practice address
66 SUNSET STRIP, STE 208, SUCCASUNNA, NJ 07876
(973) 252-0333
(973) 252-0220
Mailing address
66 SUNSET STRIP, STE 208, SUCCASUNNA, NJ 07876
(973) 252-0333
(973) 252-0220
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA03332600
NJ
207X00000X
Orthopaedic Surgery Physician
Primary
25MA03332600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110942
MEDICARE PTAN
NJ
Enumeration date
03/17/2006
Last updated
03/31/2014
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