Provider Demographics
NPI:1154546000
Name:PETRIE, AMY R (MD)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:R
Last Name:PETRIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:RUTH
Other - Last Name:SADOWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5800 HERITAGE LANDING DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9378
Mailing Address - Country:US
Mailing Address - Phone:315-445-2701
Mailing Address - Fax:315-445-2847
Practice Address - Street 1:5800 HERITAGE LANDING DR
Practice Address - Street 2:SUITE C
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9378
Practice Address - Country:US
Practice Address - Phone:315-445-2701
Practice Address - Fax:315-445-2847
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243100207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology