Individual
DR. DANIEL PETER PETRYLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
35 PARK STREET, NP-4, NEW HAVEN, CT 06510-1110
(203) 200-4822
Mailing address
789 HOWARD AVE, FMP312, NEW HAVEN, CT 06519
(203) 737-8076
(203) 785-4043
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
164174
NY
207RX0202X
Medical Oncology Physician
Primary
51405
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01412344
—
NY
Enumeration date
08/01/2006
Last updated
02/12/2014
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