Andrew John Petulla in San Jose - Specialist
Andrew John Petulla - NPI 1063426807
Andrew John Petulla is a Specialist in San Jose, California. Andrew John Petulla practices all healthcare services and medical treatments related to Specialist. The NPI Number for Andrew John Petulla is 1063426807. The last update date is 2007-07-08.
Andrew John Petulla's current location address is 2048 Lincoln Ave, San Jose, California. You can contact this provider via phone number 4084481677 and fax number 4084487060. The mailing address for Andrew John Petulla is 2048 Lincoln Ave, San Jose, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Andrew John Petulla |
|---|---|
| Address | 2048 Lincoln Ave, San Jose, California |
| Phone Number | 4084481677 |
| Fax Number | 4084487060 |
| Sole Proprietor | Y |
| Credentials | P.T. |
NPI Number Detail
| NPI Number | 1063426807 |
|---|---|
| Provider Enumeration Date | 2006-07-28 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2048 Lincoln Ave |
|---|---|
| City | San Jose |
| State | California (CA) |
| Post Code | 951253449 |
| Phone Number | 4084481677 |
| Fax Number | 4084487060 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | PT15558 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Post Comment/ Review Below
What is the Andrew John Petulla's 1063426807?
The Andrew John Petulla's NPI (National Provider Identifier) Number is 1063426807. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Andrew John Petulla's physical address?
The Andrew John Petulla is physically located at 2048 Lincoln Ave, in the city of San Jose, CA, with the postal code 951253449.
What is Andrew John Petulla's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Andrew John Petulla is Specialist, and the taxonomy code that categorizes this field of expertise is 174400000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1063426807 to Andrew John Petulla?
The Centers for Medicare & Medicaid Services originally issued the 1063426807 to Andrew John Petulla on 2006-07-28.
As of what date were the details pertaining to Andrew John Petulla last refreshed?
The information related to the Andrew John Petulla, including its address, specialty, and other relevant details, was last updated on 2007-07-08.