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Contact Information

PETR ITZHAK, DO
6805 MYRTLE AVE
GLENDALE, NY11385-7267
 Phone: 718-366-2242
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for PETR ITZHAK · (Male)

NPI # 1801843412
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/28/2006
Last updated 08/07/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 234430
  • NY Medicaid 02669836
Hospital affiliation(s)
  • NASSAU UNIVERSITY MEDICAL CENTER - (Acute Care)
    2201 HEMPSTEAD TURNPIKE
    EAST MEADOW, NY 11554
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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