Jason Petrilla is a Psychiatry in Boston, Massachusetts. Jason Petrilla practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for Jason Petrilla is 1548213002. The last update date is 2007-07-08.
Jason Petrilla's current location address is 330 Brookline Ave, Boston, Massachusetts. You can contact this provider via phone number 6176679745. The mailing address for Jason Petrilla is 330 Brookline Ave, Boston, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jason Petrilla |
|---|---|
| Address | 330 Brookline Ave, Boston, Massachusetts |
| Phone Number | 6176679745 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1548213002 |
|---|---|
| Provider Enumeration Date | 2006-05-18 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 330 Brookline Ave |
|---|---|
| City | Boston |
| State | Massachusetts (MA) |
| Post Code | 221554000 |
| Phone Number | 6176679745 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | 212534 |
|
Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 212534 | MA | TUFTS HEALTH PLAN | |
| J26361 | MA | BLUE CROSS BLUE SHIELD |
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What is the unique identifier code issued to Jason Petrilla by the Centers for Medicare & Medicaid Services?
The Jason Petrilla has been assigned the NPI (National Provider Identifier) 1548213002. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Jason Petrilla is geographically located?
The Jason Petrilla is physically situated at the following location: 330 Brookline Ave, Boston, MA, 221554000.
What is the Jason Petrilla's specialty and taxonomy code?
The Jason Petrilla's specialty is Psychiatry, and the corresponding taxonomy code is 2084P0800X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1548213002 to Jason Petrilla?
The Centers for Medicare & Medicaid Services originally issued the 1548213002 to Jason Petrilla on 2006-05-18.
As of what date was the information regarding Jason Petrilla, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jason Petrilla, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
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