Individual
MR. GREGORY PETROCHKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
156 CORLISS AVE, SUITE 107, JOHNSON CITY, NY 13790-2060
(607) 763-6735
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
3104221
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA143748
ME
Other
Enumeration date
06/21/2006
Last updated
04/27/2020
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