Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 36.003393 | OH |
NPI | 1053362236 |
---|---|
Provider Name | Dr. Rocco Anthony Petrozzi JR. |
First Address | Painesville, OH 44077-4679 |
Second Address | Cleveland, OH 44103-4014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 26/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000484990 | ANTHEM BCBS (01) | |
000000564733 | ANTHEM BLUE CROSS BLUE SHIELD (01) | OH |
000000564757 | ANTHEM BLUE CROSS BLUE SHIELD (01) | OH |
2675930 | (05) | OH |
358227 | STAYWELL/WELLCARE (01) | OH |
7263866 | AETNA-LIFE & CASUALTY CO. (01) | |
P00656043 | RAIL ROAD MEDICARE CFAI (01) | OH |
V10227 | (02) |