Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline Petronio

Individual provider Specialist · NPI 1174887186

Jacqueline Petronio is a Specialist in Fairport, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012
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Practice location Address checks out

55 Fallingbrook Rd
Fairport, NY 14450
Phone: (585) 626-8677
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X (NY)

Record details

NPI number1174887186
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 25, 2012
Last updated in NPPESFebruary 26, 2013
Mailing address55 Fallingbrook Rd, Fairport, NY 14450

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