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Organization
SUPERIO JAO MD PC
Active
Organization
SUPERIO JAO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUPERIO JAO MD (OWNER)
(631) 366-4550
Entity
Organization
Contact information
Practice address
278A E MAIN ST, SMITHTOWN, NY 11787-2920
(631) 366-4550
(631) 366-4556
Mailing address
278A E MAIN ST, SMITHTOWN, NY 11787-2920
(631) 366-4550
(631) 366-4556
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/02/2006
Last updated
03/19/2012
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