Petrella, Edward J
Petrella, Edward J is an individual health care provider with primary practice located at 100 Carnie Blvd Suite B-5, Voorhees NJ 08043-4512. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Petrella, Edward J can be contacted via phone (856) 751-0123.Contact Information
Primary practice address
100 Carnie Blvd Suite B-5
Voorhees NJ 08043-4512
Phone: (856) 751-0123
Fax: (856) 751-0535
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 25MA02335200 | New Jersey |
Profile Details
| NPI number | 1770582033 |
|---|---|
| LBN Legal business name | Petrella, Edward J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2005 |
| Last updated | Nov 27th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770582033 | NPPES |
| Other | 1089884 | HORIZON NJ HEALTH | |
| Other | 300047117 | HORIZON NJ HEALTH | |
| Other | 1243590 | HORIZON NJ HEALTH | |
| Other | PE000869 | HORIZON NJ HEALTH | |
| Other | 0069675000 | HORIZON NJ HEALTH | |
| Other | A3738029 | HORIZON NJ HEALTH | |
| Other | PE000869 | HORIZON NJ HEALTH | |
| Other | 0804225 | HORIZON NJ HEALTH | |
| MEDICAID | 1161407 | HORIZON NJ HEALTH |
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