Petrycki, Johanna

Petrycki, Johanna is an individual health care provider with primary practice located at 222 Middle Country Rd Suite 228, Smithtown NY 11787-2871. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Petrycki, Johanna can be contacted via phone (631) 265-1351.

Contact Information

Primary practice address
222 Middle Country Rd Suite 228 Smithtown NY 11787-2871
Phone: (631) 265-1351
Fax: (631) 265-9363
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X New York

Profile Details

NPI number 1154513117
LBN Legal business name Petrycki, Johanna
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2007
Last updated Oct 10th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154513117 NPPES
New York Other 1154513117 NPI
New York Other 012251-1 NPI

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