Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 223738 | NY |
N | 2080P0201X | Pediatric Allergist | 223738 | NY |
NPI | 1326132473 |
---|---|
Provider Name | Dr. Marie Cavuoto Petrizzo |
First Address | Hempstead, NY 11549-5000 |
Second Address | Great Neck, NY 11021-5310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 22/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02684022 | (05) | NY |
I27713 | (02) |