MEDICARE: JOSEPH J PETRONE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	141984	NY
2	2084P0804X	Child & Adolescent Psychiatry Physician	141984	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	145459	OTHER	NY	VALUE OPTIONS
2	7330732	OTHER	NY	GROUP HEALTH INC. NY
3	P571622	OTHER	NY	OXFORD (NON-PAR)

General Provider Information

NPI Number	:	1316073216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH J PETRONE M.D.

Provider Business Mailing Address
First Line	:	161 W 16TH ST
Second Line	:	SUITE 5B
City	:	NEW YORK
State	:	NY
Zip	:	10011-6286
Country	:	US
Telephone Number	:	212-675-0161
Fax Number	:	212-414-2144

Provider Business Practice Location Address
First Line	:	161 W 16TH ST
Second Line	:	SUITE 5B
City	:	NEW YORK
State	:	NY
Zip	:	10011-6286
Country	:	US
Telephone Number	:	212-675-0161
Fax Number	:	212-414-2144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	09/11/2025

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