MICHAEL PETRY (NPI# 1942731583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942731583 |
| Entity Type | Individual |
| Full Name | MICHAEL PETRY |
| Credential | M.D. |
| Practice Address |
75 N Country Rd Port Jefferson NY 11777-2119 |
| Mailing Address |
12 Jarvin Rd Port Jefferson Station NY 11776-1312 |
| Practice Telephone | 6314731320 |
| Mailing Telephone | 6317071582 |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003270422 | Michael Petry | Family Medicine | 215 Central Ave Ste 100, Louisville, KY 40208-1450 | 2016-04-12 |
| Street Address |
75 N COUNTRY RD |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718728 | John T. Mather Memorial Hospital | Psychiatric Unit | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2005-05-27 |
| 1124633169 | Ewelina Mieczkowska | Physician Assistant | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-09-15 |
| 1114546652 | Kelly Miller | Registered Nurse | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-14 |
| 1194344143 | John Lotfi | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-10 |
| 1669001897 | Robert Franklin Wilson | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-04-08 |
| 1245868611 | Tia Bimal | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-31 |
| 1427686203 | Aakash Babaria | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-29 |
| 1821626789 | Anjali Kewalramani | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
| 1578190591 | Joon Oh | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2190 | 2020-03-27 |
| 1871121848 | Sonali Nanda | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2020-03-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1356979009 | Candice Pallotta | Student in an Organized Health Care Education/Training Program | 201 W Broadway Apt 121, Port Jefferson, NY 11777-1352 | 2020-03-30 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1922568146 | Andrew Lloyd Silverman | Student in an Organized Health Care Education/Training Program | 75 N Country Rd Fl 3, Port Jefferson, NY 11777-2119 | 2019-03-22 |
| 1093247405 | Neha Datta | Student in an Organized Health Care Education/Training Program | 75 N. Country Road, Port Jefferson, NY 11777-0001 | 2017-04-03 |
| Find all providers in PORT JEFFERSON | ||||
| City | PORT JEFFERSON |
| Zip Code | 11777 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.