| Doctor Name: | ANN V PETRILLO |
| NPI Number: | 1396985057 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | UP004706M |
| Business Practice Address: | 125 Medical Campus Dr Suite 101 Lansdale, PA - 194467205 |
| Business Phone Number: | 2153615836 |
| Business Fax Number: | 2153621195 |
| Mailing Address: | 207 N Broad St, 3rd Floor PHILADELPHIA |
| State: | PA |
| Postal Code: | 191071500 |
| Phone Number: | 2674794165 |
| Fax Number: | 2154633820 |
| NPI Enumeration Date: | 02/20/2009 |
| NPI Last Update Date: | 02/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | UP004706M |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy 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. |