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NPI Code Detail

MEDICARE: DR. RORY JAMES PETTEYS MD

MEDICARE: DR. RORY JAMES PETTEYS MD
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
1207T00000XNeurological Surgery PhysicianR0777TX
2207T00000XNeurological Surgery Physician1022751MA

General Provider Information

NPI Number : 1558596627
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RORY JAMES PETTEYS MD
Provider Business Mailing Address
First Line : UNIT 33100
Second Line :
City : APO
State : AE
Zip : 09180-3100
Country : US
Telephone Number : 314-590-5838
Fax Number :
Provider Business Practice Location Address
First Line : 620 WASHINGTON ST
Second Line :
City : WINCHESTER
State : MA
Zip : 01890-1328
Country : US
Telephone Number : 781-756-7245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2009
Last Update Date : 08/26/2025

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