Individual
MS. COLLEEN PETRERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 COMMUNITY DR, MANHASSET, NY 11030-3802
(516) 562-0100
Mailing address
6871 SELFRIDGE ST, FOREST HILLS, NY 11375-5741
(917) 717-1791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2022
Last updated
01/17/2023
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