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General NPI Number Information
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NPI Number | 1164597993
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Entity Type | Organization
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Legal Business Name | LOUIS G. PETCU, M.D., P.C.
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 10 HOSPITAL DR STE 103
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City | HOLYOKE
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State | MA
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Zip | 01040-6603
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Country | US
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Telephone | 413-538-8899
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Fax | 413-538-7122
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Provider Business Mailing Address
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Address Line | 785 WILLIAMS ST #354
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City | LONGMEADOW
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State | MA
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Zip | 01106-2063
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Country | US
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Telephone | 413-538-8899
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Fax | 413-538-7122
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOUIS GEORGE PETCU
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Credential | M.D., M.S.
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Telephone | 413-538-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number | 75221
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License Number State | MA
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