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Individual

CRYSTAL JOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
240 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5009
(631) 726-8476
Mailing address
PO BOX 955, PORT JEFFERSON STATION, NY 11776-0808

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
018236
NY

Other

Enumeration date
12/10/2014
Last updated
12/10/2014
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