Individual
DR. GEORGE PETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6104
(607) 763-5148
Mailing address
33 LEWIS RD, # 2ND, BINGHAMTON, NY 13905-1040
(607) 729-8156
(607) 729-3982
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
154359
NY
2085R0202X
Diagnostic Radiology Physician
154359
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00797851
—
NY
Enumeration date
03/08/2006
Last updated
04/18/2016
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