Individual
MARK EDWARD PETRUZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC., L.M.T.
Contact information
Practice address
5225 RTE 347, PORT JEFFERSON STATION, NY 11776-2053
(631) 559-2220
Mailing address
3 HURON ST, PORT JEFFERSON STATION, NY 11776-4307
(631) 559-2220
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
2813
NY
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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