Individual
NICOLE PETTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
222 STATION PLZ N STE 509, MINEOLA, NY 11501-3893
(516) 663-2381
Mailing address
19 TYLER CT, MAHOPAC, NY 10541-2798
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
336183
NY
Other
Enumeration date
06/07/2022
Last updated
06/05/2025
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