Most Relevant Information
Provider Data
| NPI Number: | 1003439936 |
| Provider Name: | LISA PETRICCA PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/27/2020 |
| Last Updated: | 02/14/2023 |
Provider Practice Location
263 FARMINGTON AVENUE
FARMINGTON
CT
060308040
Practice Location Phone/Fax
| Phone: | 8606792100 |
| Fax: | 8606794815 |
Provider Mailing Location
263 FARMINGTON AVENUE
FARMINGTON
CT
060308040
Provider Mailing Phone/Fax
| Phone: | 8606792100 |
| Fax: | 8606794815 |