Petillo, Tina M

Petillo, Tina M is an individual health care provider with primary practice located at 340 East Northfield Road Suite 2E, Livingston NJ 07039-4892. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Petillo, Tina M can be contacted via phone (973) 533-0001.

Contact Information

Primary practice address
340 East Northfield Road Suite 2E Livingston NJ 07039-4892
Phone: (973) 533-0001
Fax: (973) 716-0306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 44503 New Jersey

Profile Details

NPI number 1962437244
LBN Legal business name Petillo, Tina M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Mar 30th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962437244 NPPES
New Jersey MEDICAID 7413505

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