Petok, Carol
Petok, Carol is an sole proprietor health care provider with primary practice located at 770 Port St , Easton MD 21601-8102. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Petok, Carol can be contacted via phone (410) 819-3395.Contact Information
Primary practice address
770 Port St
Easton MD 21601-8102
Phone: (410) 819-3395
Fax: (410) 770-5813
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LC2728 | Maryland |
Profile Details
| NPI number | 1891952339 |
|---|---|
| LBN Legal business name | Petok, Carol |
| Credentials | PH.D., L.C.P.C. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 21st, 2008 |
| Last updated | Mar 29th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891952339 | NPPES |
| Maryland | MEDICAID | 774800100 |
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