Olga V Petrova, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C50000368 Issued in DE

Practice address

2600 Glasgow Ave
Suite 100
Newark, DE 19702-4773

Phone

(302) 836-8350

Fax

(302) 836-8370

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christiana Care Quality Partners

  • Urgent Care Clinic/Center
  • Wilmington, DE
  • NPI 1881367332
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1316066038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "address_2": "SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049",
            "telephone_number": "302-234-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GLASGOW AVE",
            "address_2": "SUITE 100",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197024773",
            "telephone_number": "302-836-8350",
            "fax_number": "302-836-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROVA",
        "first_name": "OLGA",
        "middle_name": "V",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DE",
            "license": "C50000368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennay A Peterson
• Phyllis Peterson
• Raushanah J Peterson, MS. HCA, MS. OL
• Nicholas J Petrelli, MD
• Susan Eileen Petrillo, NP
• Renea Petrucci, PT, DPT
• Tara Petrucci
• Petrunich Oral Surgery
• Raymond Wayne Petrunich, D.D.S.
• Nicolle G Petticrew, B.A., CADC

• Medical Physician Assistant in Newark, DE
• Providers in Newark, DE by specialty
• Medical Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.