Individual
DR. MITCHELL ROBERT EZRIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6080 JERICHO TPKE, SUITE 206, COMMACK, NY 11725-2850
(631) 499-2212
(631) 499-2568
Mailing address
146 WICKS RD, COMMACK, NY 11725-4425
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X002077
NY
Other
Enumeration date
10/18/2005
Last updated
07/09/2007
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