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Individual

DR. MARK PETROVANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10 PARKER PL, FORDS, NJ 08863-2400
(917) 858-3293
(914) 440-5281
Mailing address
10 PARKER PL, FORDS, NJ 08863-2400
(917) 858-3293
(914) 440-5281

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
195910
NY
207Q00000X
Family Medicine Physician
56427
WI

Other

Enumeration date
07/23/2008
Last updated
03/17/2018
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