William J Petraiuolo, MD | |
36060 Euclid Ave, Suite 204, Willoughby, OH 44094 | |
(440) 602-6553 | |
(440) 602-6566 |
Full Name | William J Petraiuolo |
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Gender | Male |
Speciality | Surgery |
Location | 36060 Euclid Ave, Willoughby, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144336470 | NPI | - | NPPES |
0836975 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
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208600000X | Surgery | 35061722 (Ohio) | Primary |
Entity Name | Lake Hospital System, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952339996 PECOS PAC ID: 6002713922 Enrollment ID: O20031217000963 |
Mailing Address | Practice Location Address |
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William J Petraiuolo, MD Po Box 714328, Columbus, OH 43271-4328 Ph: (800) 354-1985 | William J Petraiuolo, MD 36060 Euclid Ave, Suite 204, Willoughby, OH 44094 Ph: (440) 602-6553 |
Jill K. Peysha, Surgery Medicare: Medicare Enrolled Practice Location: 5105 Som Center Rd #107, Willoughby, OH 44094 Phone: 440-953-5712 Fax: 440-953-5713 | |
Dr. Mark Goldberg, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 36001 Euclid Ave, Suite B-6, Willoughby, OH 44094 Phone: 440-953-2500 Fax: 440-953-2772 | |
Aviv Ben-meir, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 36100 Euclid Ave Ste 170, Willoughby, OH 44094 Phone: 440-602-6737 Fax: 440-942-0316 | |
Boris Vinogradsky, MD Surgery Medicare: Medicare Enrolled Practice Location: 36100 Euclid Ave Ste 330b, Willoughby, OH 44094 Phone: 440-953-8055 Fax: 440-953-0242 | |
Dr. Sean Mcphillips, Surgery Medicare: Not Enrolled in Medicare Practice Location: 5734 Amber Ct, Willoughby, OH 44094 Phone: 216-215-8377 | |
Richard Stein, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 5105 Som Center Road, Suite 107, Willoughby, OH 44094 Phone: 440-953-5712 Fax: 440-953-5713 |