MARY A. C. PETRELLESE BSW NPI 1356651475

NPI Information

NPI: 1356651475
Provider Name: MARY A. C. PETRELLESE, BSW
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
30 MAIN ST
SUITE 503
DANBURY, CT
ZIP 06810
Phone: (203) 743-4412
Get Directions

Mary A. C. Petrellese, BSW is a student in an organized health care education training program in Danbury, CT. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Mary A. C. Petrellese, BSW NPI is 1356651475. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

30 MAIN ST
SUITE 503
DANBURY, CT
ZIP 06810-040
Phone: (203) 743-4412
Fax: (203) 744-3500

The enumeration date for this NPI number is 10/8/2010 and was last updated on 10/8/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	008003522	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »