Provider Demographics
NPI:1659114817
Name:PETRACCA, FRANCESCO (NP)
Entity type:Individual
Prefix:
First Name:FRANCESCO
Middle Name:
Last Name:PETRACCA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 UNIVERSITY PLZ STE 205
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6208
Mailing Address - Country:US
Mailing Address - Phone:201-833-3599
Mailing Address - Fax:201-227-6207
Practice Address - Street 1:968 RIVER RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-2237
Practice Address - Country:US
Practice Address - Phone:201-969-0994
Practice Address - Fax:201-969-2453
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25NJ15370200363LP2300X
NJ26NR14472300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty