Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | 025259 | NY |
NPI | 1033242805 |
---|---|
Provider Name | Mr. Patrick James Jewels |
First Address | Babylon, NY 11702-2518 |
Second Address | Commack, NY 11725-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |