Individual
ERIC IRA MITCHNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5400 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2028
(631) 474-3000
(631) 474-2476
Mailing address
5400 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2028
(631) 474-3000
(631) 474-2476
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
179311
NY
Other
Enumeration date
06/15/2006
Last updated
04/27/2012
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