Provider Demographics
NPI:1548687437
Name:PATCH TESTING CENTERS OF EXCELLENCE- MILFORD
Entity type:Organization
Organization Name:PATCH TESTING CENTERS OF EXCELLENCE- MILFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRAZZUOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-301-5860
Mailing Address - Street 1:934 ORANGE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-1715
Mailing Address - Country:US
Mailing Address - Phone:617-645-1412
Mailing Address - Fax:203-301-5862
Practice Address - Street 1:849 BOSTON POST RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3537
Practice Address - Country:US
Practice Address - Phone:203-301-5860
Practice Address - Fax:203-301-5862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological ImmunologyGroup - Single Specialty