Active NPI
Lee A Petroski
- Physical Therapist
- Bryn Mawr, PA
National Provider Identifier
1457993974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 025678
- Practice address
- 130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121 - Phone
- (484) 337-3368
- NPI assigned
- Oct 16, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 025678 | PA | Primary |
Addresses
Primary practice location
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Mailing address
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-3368
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 |
|---|---|---|---|
| 025678 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571184000000",
"number": "1457993974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 S BRYN MAWR AVE",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103121",
"telephone_number": "484-337-3368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 S BRYN MAWR AVE",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103121",
"telephone_number": "484-337-3368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROSKI",
"first_name": "LEE",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-16",
"last_updated": "2019-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "025678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.