MEDICARE: DR. ROCCO ANTHONY PETROZZI JR. D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	36.003393	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00656043	OTHER	OH	RAIL ROAD MEDICARE CFAI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	358227	OTHER	OH	STAYWELL/WELLCARE
2	000000564733	OTHER	OH	ANTHEM BLUE CROSS BLUE SHIELD
3	000000564757	OTHER	OH	ANTHEM BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	000000484990	OTHER		ANTHEM BCBS
7	7263866	OTHER		AETNA-LIFE & CASUALTY CO.

General Provider Information

NPI Number	:	1053362236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROCCO ANTHONY PETROZZI JR. D.P.M.

Provider Business Mailing Address
First Line	:	1636 N SHORE DR
Second Line	:
City	:	PAINESVILLE
State	:	OH
Zip	:	44077-4679
Country	:	US
Telephone Number	:	440-290-5327
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 EUCLID AVE
Second Line	:	SUITE 101
City	:	CLEVELAND
State	:	OH
Zip	:	44103-4014
Country	:	US
Telephone Number	:	216-231-5612
Fax Number	:	216-721-5534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	02/26/2013

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Directions to “ DR. ROCCO ANTHONY PETROZZI JR. D.P.M.” Practice Location

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