Provider Demographics
NPI:1134279912
Name:PETRYNIAK, MAGDALENA ANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDALENA
Middle Name:ANNA
Last Name:PETRYNIAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8224 LAKENHEATH WAY APT 2
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2740
Mailing Address - Country:US
Mailing Address - Phone:415-559-1442
Mailing Address - Fax:
Practice Address - Street 1:PEDIATRIX OF MARYLAND
Practice Address - Street 2:9901 MEDICAL CENTER DRIVE, NEONATOLOGY OFFICE 3RD FLOOR
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2085
Practice Address - Country:US
Practice Address - Phone:415-559-1442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84189208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics