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General NPI Number Information
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NPI Number | 1356467559
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Entity Type | Individual
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Provider Name | WALESKA PIETRI MD
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 119 CALLEJON PATIO ROSA BO. PAMPANOS
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City | PONCE
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State | PR
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Zip | 00717-0346
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Country | US
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Telephone | 787-642-0964
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Fax | 787-840-2317
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Provider Business Mailing Address
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Address Line | 119 CALLEJON PATIO ROSA BO. PAMPANOS
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City | PONCE
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State | PR
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Zip | 00717-0346
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Country | US
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Telephone | 787-642-0964
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Fax | 787-840-2317
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10588
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License Number State | PR
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