Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
RONDOUT VALLEY FAMILY MED PC
Active
Organization
RONDOUT VALLEY FAMILY MED PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER JAMES PETRULIS D.O. (PRESIDENT)
(845) 687-9933
Entity
Organization
Contact information
Practice address
10 GAGNON DR, STONE RIDGE, NY 12484-5120
(845) 687-9933
(845) 687-9953
Mailing address
PO BOX 547, STONE RIDGE, NY 12484-0547
(845) 687-9933
(845) 687-9953
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
160527
NY
363A00000X
Physician Assistant
008467-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00950523
—
NY
01
—
10031715
CDPHN
NY
01
—
3292
GHI HMO SELECT
NY
01
—
87726
UNITED HEALTHCARE INS CO
NY
Enumeration date
06/09/2006
Last updated
10/09/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up