KAREN MARIE PETROK APRN NPI 1962423392

NPI Information

NPI: 1962423392
Provider Name: KAREN MARIE PETROK, APRN
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
226 MILL HILL AVE
3RD FLOOR
BRIDGEPORT, CT
ZIP 06610
Phone: (203) 384-3394
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Karen Marie Petrok, APRN is an acute care nurse practitioner in Bridgeport, CT with 28 years of experience. Karen Marie Petrok, APRN NPI is 1962423392. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

226 MILL HILL AVE
3RD FLOOR
BRIDGEPORT, CT
ZIP 06610-826
Phone: (203) 384-3394
Fax: (203) 384-3829

The NPI 1962423392 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 9/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	001573	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	004188779	MEDICAID	CONNECTICUT
2	S55214	MEDICARE UPIN	CONNECTICUT
3	500001237	MEDICARE PIN	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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