Provider Demographics
NPI:1821155946
Name:PETRONI, VIOLET A (RNC)
Entity Type:Individual
Prefix:
First Name:VIOLET
Middle Name:A
Last Name:PETRONI
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 CHAPPAQUA ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510
Mailing Address - Country:US
Mailing Address - Phone:914-762-4424
Mailing Address - Fax:
Practice Address - Street 1:175 TARRYTOWN RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1607
Practice Address - Country:US
Practice Address - Phone:914-761-6566
Practice Address - Fax:914-948-7712
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420026-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner