DR. LARRY PETTIS M.D.
NPI 1053433276
Specialist in Westampton, NJ

Active since April 06, 2007
204 DALE RD, WESTAMPTON, NJ 08060(609) 265-8204(609) 261-8171 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Larry Pettis M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LARRY PETTIS M.D. (NPI 1053433276) is an individual specialist in Westampton, New Jersey, licensed in New Jersey (25MA04164000) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1053433276
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. LARRY PETTISCredential: M.D.
Location Address204 DALE RDWestampton, NJ 08060-5516
Mailing Address204 Dale RdWestampton, NJ 08060-5516 · (609) 265-8204 · Fax (609) 261-8171
Fax(609) 261-8171
Sole ProprietorYes
Enumeration DateApril 6, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1053433276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in NJ · 25MA04164000
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

204 DALE RD, Westampton, NJ 08060

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larry Pettis's NPI number?

The NPI number for Larry Pettis is 1053433276. It was assigned to this individual provider in the NPPES registry on April 6, 2007.

Where is Larry Pettis located?

Larry Pettis practices at 204 Dale Rd, Westampton, NJ 08060. The listed phone number is (609) 265-8204.

What is Larry Pettis's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Larry Pettis was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.