Individual
REENA JAISWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
180 E MAIN ST STE 201, SMITHTOWN, NY 11787-2811
(631) 800-8004
Mailing address
10 MARKET PATH, SETAUKET, NY 11733-2223
(516) 652-2198
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
Primary
2715881
NY
Other
Enumeration date
03/27/2009
Last updated
06/20/2020
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