JACQUELYN MITRA

Specialist

Active Individual
NPI: 1528882743

Practice Address

299 HALLOCK AVE
Port Jefferson Station, NY 11776

Phone: (631) 469-3842

Specialties

Specialty Code Primary License
Specialist 174400000X Yes -

Frequently Asked Questions

NPI 1528882743 is the National Provider Identifier for JACQUELYN MITRA, a Specialist provider located in Port Jefferson Station, NY. This NPI was enumerated on November 13, 2024.
JACQUELYN MITRA practices at 299 HALLOCK AVE, Port Jefferson Station, NY 11776.

Quick Facts

NPI
1528882743
Type
Individual
Enumerated
Nov 13, 2024
Last Updated
Nov 13, 2024

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