Nicholas J Petriella, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00151500 Issued in NJ

Practice address

198 North Ave E
Cranford, NJ 07016-2469

Phone

(908) 967-6124

Fax

(908) 967-6126

NPI assigned

Oct 9, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Endo-Surgical Associates of Central NJ

  • Surgery Physician
  • Freehold, NJ
  • NPI 1508886383
  NPD (past)

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1972855302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 NORTH AVE EAST",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "07016",
            "telephone_number": "908-967-6124",
            "fax_number": "908-967-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 NORTH AVE E",
            "city": "CRANFORD",
            "state": "NJ",
            "postal_code": "070162469",
            "telephone_number": "908-967-6124",
            "fax_number": "908-967-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIELLA",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00151500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Pender, OTR/L
• Julia Perrotta, MA, CCC-SLP
• Charmaine Rosemarie Perry, MS, LPC, NCC
• Personal Care Podiatry LLC
• Xavier Peters, PT, DPT
• Beata Piasecki, DPT
• Thomas John Pijanowski, D.M.D.
• Kayla Pinilla, RN, BSN, CCM
• Margaret Hopkins Pipchick, RN APN BC
• Randi Kahn Pirozzi, RPH

• Medical Physician Assistant in Cranford, NJ
• Providers in Cranford, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.