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DR. MARY KOSLAP PETRACO NP
NPI 1790795896
Nurse Practitioner - Pediatrics in Amityville, NY

Active since August 09, 2006
1080 SUNRISE HIGHWAY, MAXINE S POSTAL TRI COMMUNITY HEALTH CENTER, AMITYVILLE, NY 11701(631) 854-1000(631) 854-1031 Get Directions Write a Review

NPPES record last updated: December 9, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Mary Koslap Petraco Np NPPES

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

DR. MARY KOSLAP PETRACO NP (NPI 1790795896) is an individual pediatrics provider in Amityville, New York, licensed in New York (F380420) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1790795896
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameDR. MARY KOSLAP PETRACOCredential: NP
Location Address1080 SUNRISE HIGHWAY, MAXINE S POSTAL TRI COMMUNITY HEALTH CENTERAmityville, NY 11701
Mailing Address1080 Sunrise Highway, Maxine S Postal Tri Community Health CenterAmityville, NY 11701 · (631) 854-1000 · Fax (631) 854-1031
Phone(631) 854-1000
Fax(631) 854-1031
Sole ProprietorNo
Enumeration DateAugust 9, 2006
Last NPPES UpdateDecember 9, 2011
✔ NPI 1790795896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in NY · F380420
1080 SUNRISE HIGHWAY, Amityville, NY 11701
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Other Identifiers 3

Medicaid00473170NY
Medicare PINW0332100NY
Medicare UPINS84023

Other Providers at the Same Location NPPES 5

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

HWA CHENG HSIEH MD
Internal Medicine
1080 SUNRISE HIGHWAY
AMITYVILLE, NY 11701
Suffolk County (631) 854-1048
DR. BHAVANI SRINIVASAN MD
Pediatrics
1080 SUNRISE HIGHWAY, MAXINE S POSTAL TRI COMMUNITY HEALTH CENTER
AMITYVILLE, NY 11701
Suffolk County (631) 854-1008
MS. KATHLEEN SINKIN RN
Registered Nurse (Diabetes Educator)
1080 SUNRISE HIGHWAY
AMITYVILLE, NY 11701
Suffolk County (631) 845-1006
DR. ROWENA M LOBO MD
Internal Medicine
1080 SUNRISE HIGHWAY, MAXINE POSTAL TRICOMMUNITY HEALTH
AMITYVILLE, NY 11701
Suffolk County (631) 854-1006
DR. CHI CHU C HSIEH MD
Pediatrics
1080 SUNRISE HIGHWAY
AMITYVILLE, NY 11701
Suffolk County (631) 854-1051

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 Mary Koslap Petraco's NPI number?

The NPI number for Mary Koslap Petraco is 1790795896. It was assigned to this individual provider in the NPPES registry on August 9, 2006.

Where is Mary Koslap Petraco located?

Mary Koslap Petraco practices at 1080 Sunrise Highway Maxine S Postal Tri Community Health Center, Amityville, NY 11701. The listed phone number is (631) 854-1000.

What is Mary Koslap Petraco's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Mary Koslap Petraco was last updated on December 9, 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.