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Contact Information

GEORGE A PETROSSIAN, MD
1405 OLD NORTHERN BLVD
ROSLYN, NY11576-2252
 Phone: 516-484-6777
 Fax: 516-484-0037
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for GEORGE A PETROSSIAN · (Male)

NPI # 1821093444
Status Active
Credentials MD
Entity Individual
Enumeration date 06/20/2005
Last updated 09/10/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 159502-1
  • NY Medicaid 01848737
  • NY Other 4221943 AETNA USHC - NON HMO
  • NY Other 1047935 AETNA USHC-HMO
  • NY Other 85F031 BCBS - PROVIDER I.D.
  • NY Other 3986056009 CIGNA - PROVIDER I.D.
  • NY Other 05405G GHI MEDICARE (QUEENS)
  • NY Other 2198834 GHI/FLEX SELECT/PPO
  • NY Other 000000067277 GHI/HMO PROVIDER I.D.
  • NY Other 2C8634 HEALTHNET - PROVIDER I.D.
  • NY Other 159502 AND 28446P HIP - PROVIDER I.D.
  • NY Other ZS068 OXFORD - PROVIDER I.D.
  • NY Other 1210804 UNITED HEALTHCARE
  • NY Other 19684 VYTRA - PROVIDER I.D.
Hospital affiliation(s)
  • GOOD SAMARITAN HOSPITAL MEDICAL CENTER - (Acute Care)
    1000 MONTAUK HIGHWAY
    WEST ISLIP, NY 11795
  • ST FRANCIS HOSPITAL ROSLYN - (Acute Care)
    100 PORT WASHINGTON BOULEVARD
    ROSLYN, NY 11576
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
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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