person
Ms. Johanna Petrycki, PA
Medical Physician Assistant in Smithtown, New York
NPI 1154513117

Johanna Petrycki is a Medical Physician Assistant based in Smithtown, NY and is specialized in Medical. Johanna Petrycki practices in Smithtown, NY and has the professional credentials of PA. The NPI Number for Johanna Petrycki is 1154513117 and holds a License No. (New York).

The current practice location address for Johanna Petrycki is 222 Middle Country Rd, Smithtown, NY and can be reached out via phone at 631-265-1351 and via fax at 631-265-9363.

Location: 222 Middle Country Rd, Smithtown, NY, 11787-2871
person
Provider Profile Details
NPI Number
1154513117
Provider Name
Johanna Petrycki
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
222 Middle Country Rd, Smithtown, NY, 11787-2871
Phone Number
631-265-1351
Fax Number
631-265-9363
Provider Enumeration Date
08/14/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1154513117 01 NY NPI
012251-1 01 NY LICENSE
institution
Provider Business Practice Location Address Details
Address
222 Middle Country Rd
City
State
Zip
11787-2871
Phone Number
631-265-1351
Fax Number
631-265-9363
person
Provider Business Mailing Address Details
Address
222 Middle Country Rd
City
State
Zip
11787-2871
Phone Number
631-265-1351
Fax Number
631-265-9363
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
(New York)
Definition
Definition to come...
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