Individual
GEORGIOS PETRIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
(973) 972-0037
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA05851800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009717
—
NJ
Enumeration date
07/11/2006
Last updated
07/08/2007
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