Organization
MIRZA ORTHOPEDICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CLANCY (CREDENTIALING ADMIN)
(631) 670-7700
Entity
Organization
Contact information
Practice address
290 E MAIN ST, SMITHTOWN, NY 11787-2916
(631) 361-5302
(631) 361-8607
Mailing address
994 W JERICHO TPKE STE 202A, SMITHTOWN, NY 11787-3211
(631) 670-7700
(631) 343-7760
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
07/08/2021
Last updated
01/17/2025
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