1477580843 NPI number — DR. WILLIAM FRANCIS PETRONE M.D.

Table of content: DR. WILLIAM FRANCIS PETRONE M.D. (NPI 1477580843)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477580843 NPI number — DR. WILLIAM FRANCIS PETRONE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PETRONE
Provider First Name:
WILLIAM
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477580843
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 W COLONIAL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILBRAHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01095-2117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-596-5574
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HARRINGTON MEMORIAL HOSPITAL
Provider Second Line Business Practice Location Address:
100 SOUTH STREET
Provider Business Practice Location Address City Name:
SOUTHBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-765-9771
Provider Business Practice Location Address Fax Number:
508-764-2448
Provider Enumeration Date:
06/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  57984 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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