Individual provider Active NPI

Karen Petrosino, R,N,

  • Registered Nurse
  • Sayville, NY
National Provider Identifier
1730387267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
349042 Issued in NY
Practice address
28 Pine St
Sayville, NY 11782-3208
Phone
(631) 563-1580
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 349042 NY Primary

Addresses

Primary practice location

28 Pine St
Sayville, NY 11782-3208

Mailing address

28 Pine St
Sayville, NY 11782-3208
Phone (631) 563-1580

Other identifiers 1

IdentifierTypeStateIssuer
01763097MedicaidNY

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

LicenseStateTypeSpecialty
349042NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730387267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 PINE ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823208",
            "telephone_number": "631-563-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 PINE ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823208",
            "telephone_number": "631-563-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSINO",
        "first_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "R,N,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "349042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01763097",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.