Provider Demographics
NPI:1710377700
Name:PETRONE, VERONICA
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:PETRONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PARK TER W
Mailing Address - Street 2:APT. F11
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1514
Mailing Address - Country:US
Mailing Address - Phone:646-351-3216
Mailing Address - Fax:
Practice Address - Street 1:31 PARK TER W
Practice Address - Street 2:APT. F11
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1514
Practice Address - Country:US
Practice Address - Phone:646-351-3216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0812061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical