Stephanie Petruzzo
Physician Assistant in Leesburg, VA. Individual provider (NPI-1).
NPI number1093370348
StatusActive
Last updated in NPPESMar 7, 2024
Details
- NPI
- 1093370348
- Entity type
- Individual (NPI-1)
- Name
- Stephanie Petruzzo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 2, 2019
- Certification date
- Mar 7, 2024
- Last updated
- Mar 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0110-007018 | VA | Yes |
| 363A00000X | Physician Assistant | – | – |
Practice location
19450 Deerfield Avenue, Suite 325Leesburg, VA 20176-8503
Phone 571-252-8119 · Fax 800-735-1643
Mailing address
224-D Cornwall St., NwSuite 403
Leesburg, VA 20176-2704
Phone 703-737-6010 · Fax 703-443-8643
Other practice locations
10888 Woodleaf Ln
Great Falls, VA 22066-3004
Great Falls, VA 22066-3004
Phone 703-463-6023
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