Individual
JOHN WILLIAM MCDONNELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14 TECHNOLOGY DR, SETAUKET, NY 11733-3472
(631) 444-4233
Mailing address
14 TECHNOLOGY DR, SETAUKET, NY 11733-3472
(631) 444-4233
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
025301
NY
363AS0400X
Surgical Physician Assistant
Primary
025301
NY
Other
Enumeration date
07/24/2020
Last updated
04/10/2021
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