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Contact Information

KERRI A PETITPAIN
18 SCOTT LN
MANORVILLE, NY11949-2624
 Phone: 631-905-6890
 Fax: 888-920-2296
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KERRI A PETITPAIN · (Female)

NPI # 1760621304
Status Active
Credentials
Entity Individual
Enumeration date 02/04/2009
Last updated 04/02/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 333951
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY 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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