Individual
DR. PERI PETRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
170 PROSPECT AVE, SUITE 4, HACKENSACK, NJ 07601-1820
(201) 488-2288
(201) 488-2298
Mailing address
170 PROSPECT AVE, SUITE 4, HACKENSACK, NJ 07601-1820
(201) 488-2288
(201) 488-2298
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
MA43597
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA43597
STATE LICENSE NUMBER
NJ
Enumeration date
03/03/2006
Last updated
08/08/2012
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