Analisa Pettus PA

NPI 1174658991 - Physician Assistant - 363A00000X

NPI Details
NPI 1174658991
Gender Female
Enumeration Date 02/22/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1400 PELHAM PKWY S
BRONX NY, 10461-1138, US
Phone (718) 918-3060
Fax
Business Location
15071 116TH AVE
JAMAICA NY, 11434-1507, US
Phone
Fax
Toxanomy
Taxonomy Code 363A00000X
License State New York
License Number 011513-1
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According to our database, Analisa Pettus PA NPI is 1174658991, taxonomy code is 363A00000X and license number is 011513-1, license state is located at New York. Analisa Pettus PA physically located at 1400 Pelham Pkwy S, Bronx NY, 10461-1138. NPI Number Analisa Pettus PA has the Individual type.

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1174658991 NPI number is provided on an as is basis without warranty of any kind. 1174658991 is maintained by the National Plan & Provider Enumeration System. The contents of Analisa Pettus PA are for informational purposes only.