Individual
GEORGE C PETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 BELLE TERRE RD, SUITE 205, PORT JEFFERSON, NY 11777-2316
(631) 473-4753
(631) 473-4760
Mailing address
625 BELLE TERRE RD, SUITE 205, PORT JEFFERSON, NY 11777-2316
(631) 473-4753
(631) 473-4760
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
145336
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660802
—
NY
Enumeration date
08/23/2005
Last updated
07/08/2007
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