Louis J. Petracca, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

25MA04021600 Issued in NJ

Practice address

332 Bloomfield Ave
Bloomfield, NJ 07003-4806

Phone

(973) 429-9225

Fax

(973) 566-0973

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073643136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 BLOOMFIELD AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034806",
            "telephone_number": "973-429-9225",
            "fax_number": "973-566-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 BLOOMFIELD AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034806",
            "telephone_number": "973-429-9225",
            "fax_number": "973-566-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRACCA",
        "first_name": "LOUIS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA04021600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "48464",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P635038",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002507",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna C Perris
• Nadina Persaud, MA, LAC
• Personal Counseling, P.C.
• Personal Touch Home Care of NJ, Inc.
• Christa Dellanno Pescatore, DC
• Antonio Phillips
• Diana Phillips, LPC
• Physical Therapy Gym, LLC
• Physicians Medical Laboratories Inc
• Danielle Maria Pillot, COTA/L

• Pulmonary Disease Physician in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Pulmonary Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.