Individual
NICHOLAS J PETRIELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
198 NORTH AVE E, CRANFORD, NJ 07016-2469
(908) 967-6124
(908) 967-6126
Mailing address
198 NORTH AVE EAST, CRANFORD, NJ 07016
(908) 967-6124
(908) 967-6126
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00151500
NJ
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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