Doctor Name: | ANGELA M PETRONIO |
NPI Number: | 1699881284 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 031698 |
Business Practice Address: | 300 Western Blvd Ste A Glastonbury, CT - 060334305 |
Business Phone Number: | 8606571920 |
Business Fax Number: | 8606571925 |
Mailing Address: | 2139 Silas Deane Hwy, ROCKY HILL |
State: | CT |
Postal Code: | 060672336 |
Phone Number: | 8602574131 |
Fax Number: | 8602574519 |
NPI Enumeration Date: | 08/23/2006 |
NPI Last Update Date: | 06/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 031698 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |