Petrosky, Keith Daniel

Petrosky, Keith Daniel is an individual health care provider with primary practice located at 1078 W Baltimore Pike Health Care Center I, Suite 206, Media PA 19063-5105. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Petrosky, Keith Daniel can be contacted via phone (484) 444-0366.

Contact Information

Primary practice address
1078 W Baltimore Pike Health Care Center I, Suite 206 Media PA 19063-5105
Phone: (484) 444-0366
Fax: (610) 565-1425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS004244L Pennsylvania

Profile Details

NPI number 1699733261
LBN Legal business name Petrosky, Keith Daniel
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699733261 NPPES
Pennsylvania Other 2123008 UNITED HEALTHCARE
Pennsylvania Other 2119379 UNITED HEALTHCARE
Pennsylvania Other 0390500000 UNITED HEALTHCARE

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