Individual provider Active NPI

Gregory Joseph Petronzi, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1427541028
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
022687 Issued in NY
Practice address
49 W 24TH St Ste 506
New York, NY 10010-3206
Phone
(917) 946-1668
NPI assigned
Jun 8, 2018
Last updated
Jun 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 022687 NY Primary

Addresses

Primary practice location

49 W 24TH St Ste 506
New York, NY 10010-3206

Mailing address

23 Rutgers St
Maplewood, NJ 07040-2803
Phone (973) 886-4005

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
022687NYMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1427541028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 RUTGERS ST",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402803",
            "telephone_number": "973-886-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 W 24TH ST STE 506",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100103206",
            "telephone_number": "917-946-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONZI",
        "first_name": "GREGORY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "022687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.