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1598141053
EDITA PETILOS LUANSING
RIDGEWOOD, NJ
NPI
1598141053
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LW0102X Nurse Practitioner, Women's Health
(Licence: NJ 26NJ00576300)
Enumeration Date
2015-08-07
Last Update Date
2021-04-13
Business Address
Mrs. EDITA PETILOS LUANSING WHNP-BC
317 FRANKLIN AVE
RIDGEWOOD, NJ 07450-3316
Phone number: 201-447-1620
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Mailing Address
Mrs. EDITA PETILOS LUANSING WHNP-BC
317 FRANKLIN AVE
RIDGEWOOD, NJ 07450-3316
Phone number: 201-447-1620
Copy
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