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

Individual provider Pediatric Nurse Practitioner · NPI 1396931770

Mary Catherine Petriccione, CPNP is a Nurse Practitioner in New York, New York. Qualified in 1986, 40 years ago. Practices with Memorial Pediatric Group, a 39-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
40
Licensed in
NY
In the registry since
2007
What do these letters mean?
CPNP — Certified Pediatric Nurse Practitioner
A nurse practitioner certified in paediatrics.

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Practice location Address checks out

1275 York Ave
New York, NY 10065-6007
Phone: (212) 639-2153
Fax: (212) 639-7107
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence F380212-1 (NY)

Record details

NPI number1396931770
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP
Sole proprietorNo
NPI enumeratedSeptember 19, 2007
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Group practice Memorial Pediatric Group — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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