Provider Demographics
NPI:1710927488
Name:PETIT, NANCY F (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:F
Last Name:PETIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 824804
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-4804
Mailing Address - Country:US
Mailing Address - Phone:302-421-4775
Mailing Address - Fax:302-421-4777
Practice Address - Street 1:701 N CLAYTON ST
Practice Address - Street 2:MOB SUITE 505
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3165
Practice Address - Country:US
Practice Address - Phone:302-421-4775
Practice Address - Fax:302-421-4777
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0005047207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1989061Medicare PIN
G64688Medicare UPIN
1989061Medicare ID - Type Unspecified