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Contact Information

DOUGLAS M PETRACO, MD
6 TECHNOLOGY DR STE 100
EAST SETAUKET, NY11733-4079
 Phone: 631-689-6698
 Fax: 631-751-5548
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Adult Reconstructive Orthopaedic Surgery

207XS0114X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for DOUGLAS M PETRACO · (Male)

NPI Number 1922021476
Status Active
Credentials MD
Entity Individual
Enumeration date 07/25/2006
Last updated 03/18/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 195619
  • NY Medicaid 02011645
Hospital affiliation(s)
  • ST CATHERINE OF SIENA HOSPITAL - (Acute Care)
    50 ROUTE 25A
    SMITHTOWN, NY 11787
  • ST CHARLES HOSPITAL - (Acute Care)
    200 BELLE TERRE ROAD
    PORT JEFFERSON, NY 11777
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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