Individual provider · Type 1 NPI
Larry Pettis, MD
Specialist · Westampton, NJ
NPI number
1053433276
Active
Practice location
204 Dale Rd
Westampton, NJ 08060-5516
Fax (609) 261-8171
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 25MA04164000 (NJ) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
About NPI 1053433276
Larry Pettis, MD's National Provider Identifier is 1053433276, issued on Apr 6, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Westampton, NJ. The record was last updated on Jul 8, 2007.