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General NPI Number Information
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NPI Number | 1205150091
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Entity Type | Organization
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Legal Business Name | ROSELLE C. PETTORINO MD, PA
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 864 CENTRAL BLVD STE 300
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City | BROWNSVILLE
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State | TX
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Zip | 78520-7539
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Country | US
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Telephone | 956-541-6311
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Fax | 956-541-6387
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Provider Business Mailing Address
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Address Line | 864 CENTRAL BLVD STE 300
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City | BROWNSVILLE
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State | TX
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Zip | 78520-7539
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Country | US
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Telephone | 956-541-6311
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Fax | 956-541-6387
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Authorized Official
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Title or Position | GENERAL SURGEON
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Name | ROSELLE C. PETTORINO
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Credential | MD, PA
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Telephone | 956-541-6311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K8420
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License Number State | TX
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