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Individual

DR. DAVID MARC PETROSINO X

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
5 HAMILTON AVE # 1, AUBURN, NY 13021-4819
(315) 252-2828
(315) 255-1965
Mailing address
5 HAMILTON AVE # 1, AUBURN, NY 13021-4819
(315) 252-2828
(315) 255-1965

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
006097
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006097
LISCENCE NUMBER
NY
01
816181
MPN EMPIRE PLAN
NY
01
CO-6097-2
NYS WORKER'S COMPENSATIO
NY
Enumeration date
09/25/2006
Last updated
07/08/2007
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