| Doctor Name: | MATTHEW PETRUCCELLI |
| NPI Number: | 1073998605 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT, SCS, OCS |
| License Number: | J1-0003344 |
| Business Practice Address: | 4512 Kirkwood Hwy Ste 303 Wilmington, DE - 198085123 |
| Business Phone Number: | 3025046195 |
| Business Fax Number: | |
| Mailing Address: | 4512 Kirkwood Hwy, Ste 303 WILMINGTON |
| State: | DE |
| Postal Code: | 198085123 |
| Phone Number: | 3025046195 |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2015 |
| NPI Last Update Date: | 07/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | J1-0003344 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DE |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |