Provider Demographics
NPI:1912232661
Name:PETROWSKI, ELAINE MARIE (PCD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:MARIE
Last Name:PETROWSKI
Suffix:
Gender:F
Credentials:PCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PHELPS RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1543
Mailing Address - Country:US
Mailing Address - Phone:201-652-4662
Mailing Address - Fax:
Practice Address - Street 1:70 PHELPS RD
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1543
Practice Address - Country:US
Practice Address - Phone:201-652-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula