Provider Demographics
NPI:1942727003
Name:PETRUZZELLI, MARIA NUNZIA (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:NUNZIA
Last Name:PETRUZZELLI
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1939
Mailing Address - Country:US
Mailing Address - Phone:201-489-2727
Mailing Address - Fax:201-489-5040
Practice Address - Street 1:130 KINDERKAMACK RD STE 300
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1931
Practice Address - Country:US
Practice Address - Phone:201-489-2727
Practice Address - Fax:201-489-5040
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00707000363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health