Dominique Leigh Petrie, PA-C

NPI #1205251014 in Merrick, New York

Provider Information

NPI Number: 1205251014
Entity Type: Individual
Name: Dominique Leigh Petrie, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Mar 3, 2014
Last Updated: Mar 3, 2014

Practice Location

Address: 1732 ALEXIS RD
City: Merrick
State: New York
ZIP Code: 11566-4821
Phone: (516) 606-0697

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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