Provider Demographics
NPI:1164597993
Name:LOUIS G. PETCU, M.D., P.C.
Entity Type:Organization
Organization Name:LOUIS G. PETCU, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:PETCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:413-538-8899
Mailing Address - Street 1:785 WILLIAMS ST
Mailing Address - Street 2:#354
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-2063
Mailing Address - Country:US
Mailing Address - Phone:413-538-8899
Mailing Address - Fax:413-538-7122
Practice Address - Street 1:10 HOSPITAL DR
Practice Address - Street 2:STE 103
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6603
Practice Address - Country:US
Practice Address - Phone:413-538-8899
Practice Address - Fax:413-538-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75221207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty