Jeffry Petrosevich

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

36 Cordage Park Cir
Suite 305a
Plymouth, MA 02360-7331

Phone

(508) 830-3444

NPI assigned

Mar 16, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1508227752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 257",
            "city": "MANOMET",
            "state": "MA",
            "postal_code": "023450257",
            "telephone_number": "857-939-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 CORDAGE PARK CIR",
            "address_2": "SUITE 305A",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607331",
            "telephone_number": "508-830-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSEVICH",
        "first_name": "JEFFRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter T Cressman DMD PC
• Sinead Marie Petersen, PH.D., LMHC., BCBA.,
• Heather Petitpas, LMHC
• Janet Elizabeth Petrella, L.I.C.S.W.
• Kayla A Petrie, BCBA
• Curtis James Petruzzelli, MD
• John Richard Pettinato, D.O.
• Iris Mae Pevzner, RBT
• Mark Pham, D.M.D.
• Peter Tan Phan, D.M.D.

• Counselor in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.