Individual
DR. KEITH DANIEL PETROSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
308 EXTON CMNS, EXTON, PA 19341-2450
(610) 363-6155
(610) 363-6116
Mailing address
308 EXTON CMNS, EXTON, PA 19341-2450
(610) 363-6155
(610) 363-6116
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS004244L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001662734
IBC PERSONAL CHOICE
PA
01
—
0390500000
AMERIHEALTH
PA
01
—
2119379
CIGNA
PA
01
—
2123008
UNITED HEALTHCARE
PA
01
—
354872000
MAGELLAN
PA
Enumeration date
05/03/2006
Last updated
08/20/2024
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