Provider Demographics
NPI:1629032537
Name:PETRONIO, ROBERT C JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:PETRONIO
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:17 BEDFORD DR
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-2201
Mailing Address - Country:US
Mailing Address - Phone:315-796-7446
Mailing Address - Fax:315-792-6911
Practice Address - Street 1:485 FRENCH RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5987
Practice Address - Country:US
Practice Address - Phone:315-792-4669
Practice Address - Fax:315-792-6911
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY037540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist