Active NPI
Peter David Fetiak Jr.
- Art Therapist
- Smithtown, NY
National Provider Identifier
1275482838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 05-P127291-01
- Practice address
- 80 Maple Ave Ste 201
Smithtown, NY 11787-3520 - Phone
- (631) 306-4284
- NPI assigned
- Jan 27, 2026
- Last updated
- Jan 27, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 05-P127291-01 | NY | Primary |
Addresses
Primary practice location
80 Maple Ave Ste 201
Smithtown, NY 11787-3520
Mailing address
2 Tree CT
East Setauket, NY 11733-1015
Phone (631) 689-8441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-P127291-01 | NY | MD | Art Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Therapy LCSW PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Smithtown, NY
- NPI 1093336307
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769472000000",
"number": "1275482838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 TREE CT",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117331015",
"telephone_number": "631-689-8441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 MAPLE AVE STE 201",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117873520",
"telephone_number": "631-306-4284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETIAK",
"first_name": "PETER",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-01-27",
"last_updated": "2026-01-27",
"certification_date": "2026-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "NY",
"license": "05-P127291-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.