Individual
DR. GRZEGORZ PETRYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8900 VAN WYCK EXPY, ACC, JAMAICA, NY 11418-2897
(718) 206-5000
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-7700
(631) 454-4163
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
205221
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01828546
—
NY
Enumeration date
10/31/2006
Last updated
07/08/2007
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