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THEODORE M PETKOV MD
NPI 1184616575
Emergency Medicine in Johnson City, NY

Active since August 22, 2005
33-57 HARRISON ST, JOHNSON CITY, NY 13790(607) 763-6412(607) 763-5854 Get Directions Write a Review

NPPES record last updated: November 19, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Theodore M Petkov Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE M PETKOV MD (NPI 1184616575) is an individual emergency medicine provider in Johnson City, New York, licensed in New York (165516) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1184616575
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameTHEODORE M PETKOVCredential: MD
Location Address33-57 HARRISON STJohnson City, NY 13790-2143
Mailing Address346 Grand AveJohnson City, NY 13790-2558 · (607) 770-0025 · Fax (607) 729-3982
Phone(607) 763-6412
Fax(607) 763-5854
Sole ProprietorNo
Enumeration DateAugust 22, 2005
Last NPPES UpdateNovember 19, 2011
✔ NPI 1184616575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in NY · 165516
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
33-57 HARRISON ST, Johnson City, NY 13790
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Other Identifiers 3

Medicare PINBB6769NY
Medicare UPINF26733
Medicaid01740303NY

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TASNIMA RIA ELAHI MD
Hospitalist
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6622
ZACHARY RONALD SECOR OTR/L
Occupational Therapist
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6000
CAMRYN PERRI
Physician Assistant
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6412
DR. VINCENT MONTONE MD
Radiology (Diagnostic Radiology)
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6104
DR. GANG YUE M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6151
JOHN PETER ZEVAN DO
Emergency Medicine
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6611
ASHLEY N HAMMOND MS, FNP
Nurse Practitioner (Family)
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6622
PARVEZ JAFRI M.D.
Hospitalist
33-57 HARRISON ST
JOHNSON CITY, NY 13790
Broome County (607) 763-6622

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Petkov's NPI number?

The NPI number for Theodore Petkov is 1184616575. It was assigned to this individual provider in the NPPES registry on August 22, 2005.

Where is Theodore Petkov located?

Theodore Petkov practices at 33-57 Harrison St, Johnson City, NY 13790. The listed phone number is (607) 763-6412.

What is Theodore Petkov's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

When was this NPI record last updated?

The NPPES record for Theodore Petkov was last updated on November 19, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.