| Albert T Petrosino Md & Mehrzad Ghafghaichi Md Ptr | |
|
2902 59th St W Ste E Bradenton FL 34209-7021 | |
| (941) 794-5732 | |
| (941) 795-5517 |
| Full Name | Albert T Petrosino Md & Mehrzad Ghafghaichi Md Ptr |
|---|---|
| Speciality | Internal Medicine |
| Location | 2902 59th St W Ste E, Bradenton, Florida |
| Authorized Official Name and Position | Albert T Petrosino (DOCTOR) |
| Authorized Official Contact | 9417945732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Albert T Petrosino Md & Mehrzad Ghafghaichi Md Ptr 2902 59th St W Ste E Bradenton FL 34209-7021 Ph: (941) 794-5732 | Albert T Petrosino Md & Mehrzad Ghafghaichi Md Ptr 2902 59th St W Ste E Bradenton FL 34209-7021 Ph: (941) 794-5732 |
| NPI Number | 1083822290 |
|---|---|
| Provider Enumeration Date | 05/19/2007 |
| Last Update Date | 05/05/2010 |
| Medicare PECOS PAC ID | 2567590995 |
|---|---|
| Medicare Enrollment ID | O20100505001009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083822290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME67012 (Florida) | Primary |
| Provider Name | Albert Thaddeus Petrosino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386641561 PECOS PAC ID: 5890823157 Enrollment ID: I20100506000909 |
| Provider Name | Mehrzad Ghafghaichi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811994098 PECOS PAC ID: 9335277698 Enrollment ID: I20100507000082 |
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