Individual
PETRINA NICOLE FEDERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9500 EUCLID AVE, A-60, CLEVELAND, OH 44195-0001
(800) 223-2273
Mailing address
9500 EUCLID AVE, A60, CLEVELAND, OH 44195-0001
(216) 444-5415
(216) 444-9419
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003033
OH
Other
Enumeration date
04/02/2010
Last updated
12/28/2011
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