Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A84189 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | A84189 | CA |
NPI | 1134279912 |
---|---|
Provider Name | Dr. Magdalena Anna Petryniak |
First Address | Potomac, MD 20854-2740 |
Second Address | Rockville, MD 20850-2085 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 15/11/2019 |