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NPI Code Detail

MEDICARE: ANGELO F. PETROLLA

MEDICARE: ANGELO F. PETROLLA
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
1213E00000XPodiatrist36.001767OH

General Provider Information

NPI Number : 1861663858
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGELO F. PETROLLA
Provider Business Mailing Address
First Line : 3507 CANFIELD RD
Second Line : SUITE 7
City : YOUNGSTOWN
State : OH
Zip : 44511-2859
Country : US
Telephone Number : 330-793-0566
Fax Number :
Provider Business Practice Location Address
First Line : 924 YOUNGSTOWN POLAND RD
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-1305
Country : US
Telephone Number : 330-707-1360
Fax Number : 330-707-1359
Authorized Official
Title or Position : OFFICE MANAGER
Name : JOANNE SCHULICK
Credential :
Telephone Number : 330-793-0566
Provider Enumeration Date : 03/18/2008
Last Update Date : 03/18/2008

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Directions to “ANGELO F. PETROLLA ” Practice Location

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