Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 25MA09417600 | NJ |
N | 208000000X | Pediatrician | FP4314477 | NJ |
N | 2080N0001X | Neonatal-Perinatal Doctor | 233095 | NY |
N | 2080N0001X | Neonatal-Perinatal Doctor | 25MA09417600 | NJ |
N | 2080N0001X | Neonatal-Perinatal Doctor | A90372 | CA |
N | 2080N0001X | Neonatal-Perinatal Doctor | FP4314477 | NJ |
NPI | 1083852958 |
---|---|
Provider Name | Dr. Jeffrey Petrozzino |
First Address | West Deptford, NJ 08096-3145 |
Second Address | West Deptford, NJ 08096 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2009 |
Last Update Date | 17/10/2018 |