MACKENZIE RYAN PETTINELLA — Medicare Enrolled Provider (PRACTITIONER - PHYSICIAN ASSISTANT, NY)
MACKENZIE RYAN PETTINELLA — Medicare Enrolled Provider (PRACTITIONER - PHYSICIAN ASSISTANT, NY) is one of 9,000 enrolled providers in the MedicareEnroll dataset. Key details — Name: MACKENZIE RYAN PETTINELLA; Type: Individual; NPI: 1003257809.
| Name | MACKENZIE RYAN PETTINELLA |
|---|---|
| Type | Individual |
| NPI | 1003257809 |
| Provider type | PRACTITIONER - PHYSICIAN ASSISTANT |
| State | NY |
| Enrollment ID | I20130729000410 |
| Multiple NPI flag | N |
| Source | CMS Medicare FFS Public Provider Enrollment (PECOS) |
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