Claudia Jennifer Petaccio, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA06406500 Issued in NJ

Practice address

300 E Park Ave
Haddonfield, NJ 08033-1637

Phone

(856) 427-4218

NPI assigned

Jun 4, 2013

Last updated

Feb 10, 2020By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Kennedy Medical Group Practice, P.C.

  dba Jefferson Health

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1649617325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 FRIES MILL RD STE 301",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122016",
            "telephone_number": "856-374-1881",
            "fax_number": "856-302-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E PARK AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080331637",
            "telephone_number": "856-427-4218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Fries Mill Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Turnersville",
            "state": "NJ",
            "postal_code": "080122016",
            "country_code": "US",
            "telephone_number": "856-374-1881",
            "fax_number": "856-302-1961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETACCIO",
        "first_name": "CLAUDIA",
        "middle_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA06406500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7077807",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bob Pekar, L.C.S.W.
• Gale Pekar, RN,LPC
• Lanibelle Pena, PHARM.D
• Rosemunde Marcia Christine Percival, LLC OWNER
• Kerry Perez
• Linda Michelle Petrovich, MD
• John W Petrozzi, M.D
• Rachel Petrucci, PT, DPT
• Nicole Pittella
• Laureen M Pladdys, DC

• Internal Medicine Physician in Haddonfield, NJ
• Providers in Haddonfield, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.