Edmund Stephen Petrilli, M.D., P.C.
Organization Active NPI Gynecologic Oncology Physician · Manassas, VA
NPI 1407037500 · NPPES record last updated Nov 19, 2007
Key facts
- NPI
- 1407037500
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gynecologic Oncology Physician 207VX0201X
- License
- 0101022700 (VA)
- Legal business name
- EDMUND STEPHEN PETRILLI, M.D., P.C.
- Practice address
- 8650 Sudley Rd
Suite 200
Manassas, VA 20110-4419 - Phone
- (703) 392-5157
- Fax
- (703) 392-1347
- NPI assigned
- Nov 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Edmund Stephen Petrilli, MD
- Title
- President
- Phone
- (703) 830-8403
Practitioners 2
-
Larry Allen Nance, M.D.
National Provider Directory
Locations
8640 Sudley Rd
Ste 302
Manassas, VA 20110
Phone (703) 369-5959
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician |
207VG0400X | 0101022700 | VA | |
| Gynecologic Oncology Physician |
207VX0201X | 0101022700 | VA | Yes |
Addresses
Primary practice location
8650 Sudley Rd
Suite 200
Manassas, VA 20110-4419
Mailing address
8650 Sudley Rd
Suite 200
Manassas, VA 20110-4419
Phone (703) 392-5157
Other providers in Manassas, VA
- David Ethan Ebbecke
- Olivia Ebey
- Theophiline Mary Ebiasah
- Raymond Eck
- Christopher David Edens
- Natasha Shannon Edwards
- Sara Elizabeth Edwards
- Alan C Egge
- Darryl Lyn Einhorn
- Kossi Pierre Eklou
All providers in Manassas, VA · Gynecologic Oncology Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.