Petracca, Anthony

Petracca, Anthony is an individual health care provider with primary practice located at 3 Irongate Center , Glens Falls NY 12801-3471. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Petracca, Anthony can be contacted via phone (518) 793-4409.

Contact Information

Primary practice address
3 Irongate Center Glens Falls NY 12801-3471
Phone: (518) 793-4409
Fax: (518) 793-5886
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 167575 New York

Profile Details

NPI number 1487636874
LBN Legal business name Petracca, Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2005
Last updated Feb 13th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487636874 NPPES
New York Other 000401245001 BLUE SHIELD NENY
New York Other CD1981 BLUE SHIELD NENY
New York Other 10470641 BLUE SHIELD NENY
New York Other 5500215 BLUE SHIELD NENY
New York MEDICAID 01346818 BLUE SHIELD NENY
New York Other 10002650 BLUE SHIELD NENY
New York Other 56K521 BLUE SHIELD NENY
New York Other 000000056116 BLUE SHIELD NENY
New York Other 00020592301 BLUE SHIELD NENY
New York Other 021200700350 BLUE SHIELD NENY
New York Other 08219 BLUE SHIELD NENY

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