Nicholas Petrucelli, CAC III

NPI 1538461124 · on the registry since 2010 · sole proprietor

Practice

Address: 7251 E 49th Ave
Commerce City, CO 80022
Phone: (303) 468-6191
Fax: (303) 321-3556
Organisation at this address: Stout Street Foundation
Stout Street Foundation
The Stout Street Foundation
The Stout Street Foundation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 10

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Licence states on file: CO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2014-01-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado