Provider Demographics
NPI:1134136567
Name:LOEHRIG, TRICIA M (DO)
Entity Type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:M
Last Name:LOEHRIG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:MARY
Other - Last Name:PETRUCELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2981 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1024
Mailing Address - Country:US
Mailing Address - Phone:215-632-4550
Mailing Address - Fax:215-632-7865
Practice Address - Street 1:2981 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1024
Practice Address - Country:US
Practice Address - Phone:215-632-4550
Practice Address - Fax:215-632-7865
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0133262083B0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine