Nicholas J Petrelli, MD

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

C1-0006443 Issued in DE

Practice address

4701 Ogletown Stanton Rd
Suite 1213
Newark, DE 19713-2055

Phone

(302) 623-4550

Fax

(302) 623-4554

NPI assigned

Jan 19, 2006

Sex

Male

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

Doctor of Medicine

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1629058201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30170",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198057170",
            "telephone_number": "302-623-7362",
            "fax_number": "302-623-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 OGLETOWN STANTON RD",
            "address_2": "SUITE 1213",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132055",
            "telephone_number": "302-623-4550",
            "fax_number": "302-623-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRELLI",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "DE",
            "license": "C1-0006443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Petersen, DC
• Nicholas Colin Petersen
• Jennay A Peterson
• Phyllis Peterson
• Raushanah J Peterson, MS. HCA, MS. OL
• Susan Eileen Petrillo, NP
• Olga V Petrova, PA-C
• Renea Petrucci, PT, DPT
• Tara Petrucci
• Petrunich Oral Surgery

• Surgical Oncology Physician in Newark, DE
• Providers in Newark, DE by specialty
• Surgical Oncology Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.