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NPI Code Detail

MEDICARE: ALEXANDER PETTI

MEDICARE: ALEXANDER PETTI
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
1207P00000XEmergency Medicine Physician1015162MA
2207P00000XEmergency Medicine Physician307415NY
3390200000XStudent in an Organized Health Care Education/Training Program
4207RC0200XCritical Care Medicine (Internal Medicine) Physician1015162MA

General Provider Information

NPI Number : 1588195630
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER PETTI
Provider Business Mailing Address
First Line : 81 HIGHLAND AVE
Second Line :
City : SALEM
State : MA
Zip : 01970-2714
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 81 HIGHLAND AVE
Second Line :
City : SALEM
State : MA
Zip : 01970-2768
Country : US
Telephone Number : 978-741-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2017
Last Update Date : 05/08/2023

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Directions to “ ALEXANDER PETTI ” Practice Location

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