Provider Demographics
NPI:1518641497
Name:PETRELLI, ALESSANDRA (PA-C)
Entity Type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:PETRELLI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CURTIS DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2154
Mailing Address - Country:US
Mailing Address - Phone:508-649-3818
Mailing Address - Fax:
Practice Address - Street 1:1690 CROWN COLONY DR
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0913
Practice Address - Country:US
Practice Address - Phone:857-403-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant