Edmund S Petrilli
Gynecologist Gynecologic Oncologist
9304 Forest Point Cir
Manassas
, Virginia 20110-4700
Edmund S Petrilli
Gynecologist Gynecologic Oncologist
9304 Forest Point Cir
Manassas
, Virginia 20110-4700
(703) 369-4164
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About
Features
Specialties
- Gynecologist
- Gynecologic Oncologist
Languages spoken
- English
Location
First Address
- Edmund S Petrilli
- 9304 Forest Point Cir
- Manassas, VA
- Zip : 20110-4700
- Fax : (703) 369-4164
- Phone : (703) 368-1969
Second Address
- Edmund S Petrilli
- 9304 Forest Point Cir
- Manassas, VA
- Zip : 20110-4700
- Fax : (703) 369-4164
- Phone : (703) 368-1969
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207VG0400X | Gynecologist | 0101022700 | VA |
| Y | 207VX0201X | Gynecologic Oncologist | 0101022700 | VA |
National Provider Identifier
| NPI | 1154323004 |
|---|---|
| Provider Name | Edmund S Petrilli |
| First Address | Manassas, VA 20110-4700 |
| Second Address | Manassas, VA 20110-4700 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/08/2005 |
| Last Update Date | 22/10/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C35984 | (02) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.