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Organization
KERRI PETITPAIN MEDICAL
Active
Organization
KERRI PETITPAIN MEDICAL
Active
Other names
Kerri Petitpain Medical
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI ANN PETITPAIN DNP-C (PRACTITIONER/OWNER)
(631) 905-6890
Entity
Organization
Contact information
Practice address
18 SCOTT LN, MANORVILLE, NY 11949-2624
(631) 905-6890
(888) 920-2296
Mailing address
18 SCOTT LN, MANORVILLE, NY 11949-2624
(631) 905-6890
(888) 920-2296
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03410419
—
NY
Enumeration date
04/02/2020
Last updated
04/02/2020
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