DR. GEORGE A. PETROSSIAN (NPI# 1821093444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821093444 |
| Entity Type | Individual |
| Full Name | DR. GEORGE A. PETROSSIAN |
| Credential | M.D. |
| Practice Address |
1405 Old Northern Blvd Roslyn NY 11576-2252 |
| Mailing Address |
Po Box 95000-6600 Philadelphia PA 19195-6600 |
| Practice Telephone | 5164846777 |
| Practice Fax Number | 5164840037 |
| Mailing Telephone | 6314656297 |
| Mailing Fax Number | 6314656524 |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2014-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 159502-1 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | AETNA USHC-HMO | 1047935 | 01 |
| NY | VYTRA - PROVIDER I.D. | 19684 | 01 |
| NY | OXFORD - PROVIDER I.D. | ZS068 | 01 |
| NY | GHI MEDICARE (QUEENS) | 05405G | 01 |
| NY | HEALTHNET - PROVIDER I.D. | 2C8634 | 01 |
| NY | 01848737 | 05 | |
| NY | HIP - PROVIDER I.D. | 159502 AND 28446P | 01 |
| NY | AETNA USHC - NON HMO | 4221943 | 01 |
| NY | GHI/FLEX SELECT/PPO | 2198834 | 01 |
| NY | BCBS - PROVIDER I.D. | 85F031 | 01 |
| NY | GHI/HMO PROVIDER I.D. | 000000067277 | 01 |
| NY | UNITED HEALTHCARE | 1210804 | 01 |
| NY | CIGNA - PROVIDER I.D. | 3986056009 | 01 |
| Street Address |
1405 OLD NORTHERN BLVD |
| City | ROSLYN |
| State | NY |
| Zip Code | 11576-2252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649444373 | Maura Noel Kieran | Nurse Practitioner | 1405 Old Northern Blvd, Roslyn, NY 11576-2146 | 2008-04-14 |
| 1326234436 | Carole Rhea Zarcone | Nurse Practitioner | 1405 Old Northern Blvd, Roslyn, NY 11576-2252 | 2007-09-21 |
| 1093803892 | New York Cardiology Group, P.C. | Specialist | 1405 Old Northern Blvd, First Floor, Roslyn, NY 11576-2252 | 2006-10-10 |
| 1760488001 | Katie Staphos | Physician Assistant | 1405 Old Northern Blvd, Roslyn, NY 11576-2252 | 2005-06-22 |
| 1376549725 | Maura A. Kenney- Kieran | Nurse Practitioner | 1405 Old Northern Blvd, Roslyn, NY 11576-2252 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265075998 | Haley W Feit | Optometrist | 1085 Northern Blvd, Roslyn, NY 11576 | 2019-10-25 |
| 1346765187 | Fern Wendi Schanback | Counselor | 24 Mackay Way, Roslyn, NY 11576 | 2017-08-12 |
| 1932577574 | Soma Fit Physical Therapy Pllc | Physical Therapist | 55 Lumber Rd, Suite 105, Roslyn, NY 11576 | 2015-09-14 |
| 1679953699 | Linda D.r. Miller | Speech-Language Pathologist | 7 Woodland Road, Roslyn, NY 11576 | 2015-06-04 |
| 1629463450 | Angela Maria Taveras | Social Worker | 141 Old Northern Blvd, Rosalyn, NY 11576 | 2015-03-30 |
| 1043594922 | Robin Hananel | Speech-Language Pathologist | 29 The Oaks, Roslyn, NY 11576 | 2011-10-10 |
| 1073838207 | Lucille A Barker | Occupational Therapist | 1441old Northern Blvd, Roslyn, NY 11576 | 2010-03-31 |
| 1518100163 | Robert Eugene Goldberger | Surgery | 4 The Birches, Roslyn, NY 11576 | 2009-04-13 |
| 1336388461 | Sarah Lamattina | Counselor | 1441 Old Northern Boulevard, Roslyn, NY 11576 | 2009-02-12 |
| 1508001553 | Leslie Jane Brownstein | Speech-Language Pathologist | 174 Mimosa Drive, Roslyn, N.y 11576, New York City, NY 11576 | 2008-12-04 |
| Find all providers in zip 11576 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235755547 | Melanie Carmili | Specialist | 12 Bonnie Lynn Ct, Roslyn, NY 11576-3040 | 2020-06-23 |
| 1720595820 | Marsha Perlmutter | Specialist | 29 Fox Rdg, Roslyn, NY 11576-2827 | 2018-01-10 |
| 1215308820 | Dewi Wijaya | Specialist | 33 Ursula Dr, Roslyn, NY 11576-3020 | 2015-10-08 |
| 1205248689 | Cheryl Doustan | Specialist | 65 Dianas Trl, Roslyn, NY 11576-1825 | 2014-05-20 |
| 1831537216 | Jennifer Butts | Specialist | 54 Woods Dr, Roslyn, NY 11576-2618 | 2013-06-07 |
| 1346585742 | Stacey M Wink | Specialist | 1127 Old Northern Blvd, Roslyn, NY 11576-1607 | 2012-12-11 |
| 1922352343 | Meredith Dauman | Specialist | 5 Woodcrest Dr, Roslyn, NY 11576-3027 | 2012-11-07 |
| 1831402288 | Avigail O Grossmann | Specialist | 124 Hamilton Dr, Roslyn, NY 11576-3129 | 2010-07-14 |
| 1023297363 | Victor Chehebar | Specialist | 70 Spruce St, Roslyn, NY 11576-1211 | 2007-11-02 |
| 1649300096 | Lorraine Susan Cohn | Specialist | Beacon Therapy Services Pllc, 1441 Northern Blvd., Roslyn, NY 11576 | 2007-03-06 |
| Find all providers in ROSLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.