Angetta M Petit, CRNA | |
3900 Woodland Ave, Philadelphia, PA 19104-4551 | |
(215) 823-8500 | |
Not Available |
Full Name | Angetta M Petit |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 3900 Woodland Ave, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881830834 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | RN353993L (Pennsylvania) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 26NO10641700 (New Jersey) | Primary |
Entity Name | Virtua Medical Group, Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649226515 PECOS PAC ID: 9830222397 Enrollment ID: O20100804000338 |
Mailing Address | Practice Location Address |
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Angetta M Petit, CRNA 3900 Woodland Avenue, Philadelphia, PA 19104-9020 Ph: (215) 823-5800 | Angetta M Petit, CRNA 3900 Woodland Ave, Philadelphia, PA 19104-4551 Ph: (215) 823-8500 |
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