Individual
JOHN GREGG PETRACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
118 N COUNTRY RD, PORT JEFFERSON, NY 11777-2120
(631) 471-7171
(631) 473-4605
Mailing address
118 N COUNTRY RD, PORT JEFFERSON, NY 11777-2120
(631) 471-7171
(631) 473-4605
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
194289
NY
Other
Enumeration date
12/06/2005
Last updated
10/10/2011
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