Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 257685 | MA |
N | 2086S0105X | Surgery of the Hand | MD15993 | RI |
NPI | 1427222595 |
---|---|
Provider Name | Dr. Christian A Petrulio |
First Address | Fairhaven, MA 02719-5252 |
Second Address | North Dartmouth, MA 02747-1257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 23/04/2020 |