Dr. Nancy Jean Petrilak, O.D.
Optometrist in Langley Afb, VA. Individual provider (NPI-1).
NPI number1508089673
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1508089673
- Entity type
- Individual (NPI-1)
- Name
- Dr. Nancy Jean Petrilak
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 10, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 9998 | CA | Yes |
Practice location
1st Medical Group77 Nealy Ave
Langley Afb, VA 23665-2023
Phone 757-764-6973
Mailing address
104 Carnoustie CtYorktown, VA 23693-5517
Phone 757-969-5368
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