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Contact Information

IRINA S PETTY, PA
2000 TAMARACK RD
NEWARK, OH43055
 Phone: 220-564-4650
 Fax: 220-564-4238
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for IRINA S PETTY · (Female)

NPI # 1619211463
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 11/17/2012
Last updated 04/02/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 003613
Hospital affiliation(s)
  • LICKING MEMORIAL HOSPITAL HOMECARE - (Acute Care)
    1320 WEST MAIN STREET
    NEWARK, OH 43055
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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