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Contact Information

MARK A PETTIT
1425 PORTLAND AVENUE
ROCHESTER, NY14621
 Phone: 585-922-4000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for MARK A PETTIT · (Male)

NPI # 1487911947
Status Active
Credentials
Entity Individual
Enumeration date 04/20/2012
Last updated 08/23/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 278798
  • NY Medicaid 04239745
Hospital affiliation(s)
  • CLIFTON SPRINGS HOSPITAL AND CLINIC - (Acute Care)
    2 COULTER ROAD
    CLIFTON SPRINGS, NY 14432
  • ROCHESTER GENERAL HOSPITAL - (Acute Care)
    1425 PORTLAND AVENUE
    ROCHESTER, NY 14621
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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