Organization
JUSTIN MIRZA D.O. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN BRUNO MIRZA D.O. (PRESIDENT)
(631) 361-5302
Entity
Organization
Contact information
Practice address
290 E MAIN ST, SUITE 200, SMITHTOWN, NY 11787-2916
(631) 361-5302
(631) 361-8607
Mailing address
290 E MAIN ST, SUITE 200, SMITHTOWN, NY 11787-2916
(631) 361-5302
(631) 361-8607
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
258198
NY
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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