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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962437244 | NPPES |
| New Jersey | MEDICAID | 7413505 |
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