MEDICARE: DR. GEORGE A. PETROSSIAN 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	174400000X	Specialist	159502-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
10	05405G	OTHER	NY	GHI MEDICARE (QUEENS)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1047935	OTHER	NY	AETNA USHC-HMO
2	2198834	OTHER	NY	GHI/FLEX SELECT/PPO
3	85F031	OTHER	NY	BCBS - PROVIDER I.D.
4	159502 AND 28446P	OTHER	NY	HIP - PROVIDER I.D.
5	4221943	OTHER	NY	AETNA USHC - NON HMO
6	ZS068	OTHER	NY	OXFORD - PROVIDER I.D.
7	000000067277	OTHER	NY	GHI/HMO PROVIDER I.D.
8	1210804	OTHER	NY	UNITED HEALTHCARE
9	2C8634	OTHER	NY	HEALTHNET - PROVIDER I.D.
11	19684	OTHER	NY	VYTRA - PROVIDER I.D.
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	3986056009	OTHER	NY	CIGNA - PROVIDER I.D.

General Provider Information

NPI Number	:	1821093444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE A. PETROSSIAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 95000-6600
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19195-6600
Country	:	US
Telephone Number	:	631-465-6297
Fax Number	:	631-465-6524

Provider Business Practice Location Address
First Line	:	1405 OLD NORTHERN BLVD
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-2252
Country	:	US
Telephone Number	:	516-484-6777
Fax Number	:	516-484-0037

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	09/10/2014

Similar Medicare Providers

1376549725 — MRS. MAURA A. KENNEY- KIERAN A.N.P.-C
Practice Location Address:

1405 OLD NORTHERN BLVD
ROSLYN, NY
11576-2252

Practice Phone: 516-484-6777
Practice Fax: 516-484-0037

1760488001 — KATIE STAPHOS R.P.A.-C
Practice Location Address:

1405 OLD NORTHERN BLVD
ROSLYN, NY
11576-2252

Practice Phone: 516-484-6777
Practice Fax: 516-484-0037

1093803892 — NEW YORK CARDIOLOGY GROUP, P.C.
Practice Location Address:

1405 OLD NORTHERN BLVD , FIRST FLOOR
ROSLYN, NY
11576-2252

Practice Phone: 516-484-6777
Practice Fax: 516-484-0037

1326234436 — CAROLE RHEA ZARCONE A.N.P.
Practice Location Address:

1405 OLD NORTHERN BLVD
ROSLYN, NY
11576-2252

Practice Phone: 516-484-6777
Practice Fax: 516-484-0037

1871239152 — DR. ADRIANA MEDIAVILLA DDS
Practice Location Address:

1405 OLD NORTHERN BLVD
ROSLYN, NY
11576-2252

Practice Phone: 516-801-6777
Practice Fax:

1881155893 — DR. JAMES SAJI THOMAS DO
Practice Location Address:

100 PORT WASHINGTON BLVD
ROSLYN, NY
11576-1353

Practice Phone: 516-562-6600
Practice Fax:

Directions to “ DR. GEORGE A. PETROSSIAN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.