| Louis D Petrellis Do Ltd | |
|
723 Red Lion Rd Philadelphia PA 19115 | |
| (215) 673-2522 | |
| (215) 677-1083 |
| Full Name | Louis D Petrellis Do Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 723 Red Lion Rd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Louis Daniel Petrellis (PRESIDENT PHYSICIAN) |
| Authorized Official Contact | 2156732522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louis D Petrellis Do Ltd 723 Red Lion Rd Philadelphia PA 19115 Ph: (215) 673-2522 | Louis D Petrellis Do Ltd 723 Red Lion Rd Philadelphia PA 19115 Ph: (215) 673-2522 |
| NPI Number | 1134159312 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134159312 | NPI | - | NPPES |
| 01272990 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0S006198L (Pennsylvania) | Primary |
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