Provider Demographics
NPI:1053136689
Name:PETRONE, GLAUCE (DO)
Entity type:Individual
Prefix:
First Name:GLAUCE
Middle Name:
Last Name:PETRONE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 LYNNWAY APT 243
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1846
Mailing Address - Country:US
Mailing Address - Phone:781-962-1586
Mailing Address - Fax:
Practice Address - Street 1:254 LYNNWAY APT 243
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1846
Practice Address - Country:US
Practice Address - Phone:781-962-1586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula