Petricone, Randi A

Petricone, Randi A is an individual health care provider with primary practice located at 850 Harrison Ave Yacc 4, Boston MA 02118-4001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Petricone, Randi A can be contacted via phone (617) 414-2000.

Contact Information

Primary practice address
850 Harrison Ave Yacc 4 Boston MA 02118-4001
Phone: (617) 414-2000
Fax: (617) 414-5798
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X RN263379 Massachusetts

Profile Details

NPI number 1538369608
LBN Legal business name Petricone, Randi A
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2007
Last updated Aug 7th, 2014 - about 10 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 1538369608 NPPES
Massachusetts MEDICAID 110076888A

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